Tools to help healthcare professionals recognize palliative care needs in patients with advanced heart failure: A systematic review

Ament, Stephanie M C; Couwenberg, Inge Me; Boyne, Josiane; Kleijnen, Jos; Stoffers, Jelle; Beuken, Marieke Hj van den; Engels, Yvonne; Bellersen, Louise; Janssen, Daisy J.A.

doi:10.1177/0269216320963941

Cited by 19 publications

(21 citation statements)

References 61 publications

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“…The methodology for the identification of the tools was described elsewhere. 18 Besides existing tools related to CHF, the Support Needs Approach for Patients needs assessment tool to identify palliative support needs in advanced chronic obstructive pulmonary disease (COPD) was used to identify promising questions. 22…”

Section: Stage 1a: Systematic Reviewmentioning

confidence: 99%

“…The content of the tool elaborates on existing content and criterion validation research of tools in the context of PC and advanced CHF and on the lessons learnt from practice. 18 Moreover, the care recommendations are partly based on the Dutch multidisciplinary guideline 'PC for patients with heart failure'. 32…”

Section: Strengths Of I-harpmentioning

confidence: 99%

“…More guidance and education for HCPs about how to use I-HARP may facilitate effective and efficient application. 18 The time needed to complete I-HARP may vary due to the different roles of the HCPs and the different organisational processes and regional collaboration. Patients with CHF and family members prefer recognition of PC needs during a conversation instead of self-completing a questionnaire.…”

Section: Challenges Expected Regarding Implementation Of I-harpmentioning

confidence: 99%

“…A recent review showed that the available international tools were not fully appropriate for the Dutch setting based on the identified desired characteristics of a tool in this country. 18 The tools were developed for a specific discipline or revealed to be too complex to apply, were focused on case finding instead of identification of PC needs or were not CHF-specific. The aim of this study was to develop the content of the new tool 'Identification of patients with HeARt failure with PC needs (I-HARP)' for HCPs working in primary care, secondary care and nursing homes.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Professionals guidance about palliative medicine in chronic heart failure: a mixed-method study

Ament

Beuken-Everdingen

Maessen

et al. 2020

BMJ Support Palliat Care

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IntroductionHealthcare professionals (HCPs) experience difficulties in timely recognising and directing palliative care (PC) needs of their patients with chronic heart failure (CHF). The aim of this study was to develop a comprehensive tool to enable HCPs in timely recognising and directing PC needs in CHF.MethodsA four-stage mixed-method study was performed. Stage 1: identification of needs and questions of patients and families; stage 2: prioritisation and refinement of the needs and questions; stage 3a: testing and online feedback on V.1; stage 3b: selecting and refining care recommendations; stage 4: testing and review of V.2. Iterative reviews followed each step in the development process to ensure a wide range of stakeholder input. In total, 16 patients, 12 family members and 54 HCPs participated.ResultsA comprehensive set of 13 PC needs was identified, redefined and tested. The resulting tool, called Identification of patients with HeARt failure with PC needs (I-HARP), contains an introduction prompt with open questions to start the conversation, 13 closed screening questions with additional in-depth questions, and recommendations on actions for identified needs.ConclusionI-HARP contains an evidence-based set of questions and palliative CHF care suggestions for HCPs in the Netherlands. The resulting tool, approved by HCPs, patients and family members, is a promising guidance for HCP to timely recognise and direct PC needs in CHF.

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Section: Stage 1a: Systematic Reviewmentioning

confidence: 99%

Section: Strengths Of I-harpmentioning

confidence: 99%

Section: Challenges Expected Regarding Implementation Of I-harpmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Professionals guidance about palliative medicine in chronic heart failure: a mixed-method study

Ament

Beuken-Everdingen

Maessen

et al. 2020

BMJ Support Palliat Care

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“…These tools used as a support and a starting point for delivering patient-centered care [ 6 ]. Two recent systematic reviews found six needs measurement tools that can be used with patients with HF [ 6 , 7 ]. Both systematic reviews found that the most comprehensive of these tools and the only one created specifically for patients with HF is the “Needs Assessment Tool: Progressive Disease-Heart Failure” (NAT: PD-HF) [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Validation of the German version of the needs assessment tool: progressive disease-heart failure

González-Jaramillo

Guyer

Luethi

et al. 2021

Health Qual Life Outcomes

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Background The Needs Assessment Tool: Progressive Disease-Heart Failure (NAT: PD-HF) is a tool created to assess the needs of people living with heart failure and their informal caregivers to assist delivering care in a more comprehensive way that addresses actual needs that are unmet, and to improve quality of life. In this study, we aimed to (1) Translate the tool into German and culturally adapt it. (2) Assess internal consistency, inter-rater reliability, and test–retest reliability of the German NAT: PD-HF. (3) Evaluate whether and how patients and health care personnel understand the tool and its utility. (4) Assess the tool’s face validity, applicability, relevance, and acceptability among health care personnel. Methods Single-center validation study. The tool was translated from English into German using a forward–backward translation. To assess internal consistency, we used Cronbach´s alpha. To assess inter-rater reliability and test–retest reliability, we used Cohen´s kappa, and to assess validity we used face validity. Results The translated tool showed good internal consistency. Raters were in substantial agreement on a majority of the questions, and agreement was almost perfect for all the questions in the test–retest analysis. Face validity was rated high by health care personnel. Conclusion The German NAT: PD-HF is a reliable, valid, and internally consistent tool that is well accepted by both patients and health care personnel. However, it is important to keep in mind that effective use of the tool requires training of health care personnel.

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Validity and reliability of the palliative care needs assessment tool in Japanese patients with heart failure

Tatsuta,

Sato,

Nagai

et al. 2024

ESC Heart Failure

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AimsAlthough patients with heart failure (HF) frequently experience considerable symptom burden and require significant care, most HF patients do not receive timely intervention due to the absence of a standardized method for identifying those in need of palliative care. The Needs Assessment Tool: Progressive Disease‐Heart Failure (NAT: PD‐HF) assesses the palliative care needs of patients with HF. However, its validity and reliability have yet to be fully examined. We aimed to assess the validity and reliability of the NAT: PD‐HF in Japanese patients with HF.MethodsWe prospectively enrolled 106 consecutive patients with chronic HF admitted to our university hospital between February 2023 and July 2023. Their caregivers (n = 95) and healthcare providers (n = 17) were also included. The NAT: PD‐HF was translated from English to Japanese using a forward–backward translation procedure and adapted based on Japanese cultural and medical backgrounds by our professional multidisciplinary team. We assessed the internal consistency of the Japanese NAT: PD‐HF version with Cronbach's alpha coefficient and the inter‐rater and test–retest reliabilities with Cohen's kappa coefficient. After using the tool, all participants were asked to complete a questionnaire about the tool to determine its validity.ResultsThe proportion of female patients in this study was 47 (44%). The median age was 72 years [interquartile range (IQR) 59–81]. The median time spent assessing the patients' and their caregivers' needs using the Japanese NAT: PD‐HF was 14 min (IQR 12–17). The Cronbach's alpha coefficient was 0.82, and the minimum kappa coefficient was 0.77 for inter‐rater reliability and 0.88 for test–retest reliability. In total, 103 patients (97%) and all caregivers responded that the tool was easy to understand. One hundred (94%) patients and 89 (94%) caregivers felt that the tool would improve the quality of care, and 102 (96%) patients and 91 (96%) caregivers indicated that the discussions using this tool allowed them to confide in all their burdens and care needs. All healthcare providers expressed that this tool is helpful in understanding the burden and care needs of both patients and caregivers comprehensively.ConclusionsThe NAT: PD‐HF is a reliable and valid tool for Japanese patients with HF and their caregivers. This tool was very well accepted by patients, caregivers and healthcare providers to identify burdens and care needs.

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Tools to help healthcare professionals recognize palliative care needs in patients with advanced heart failure: A systematic review

Cited by 19 publications

References 61 publications

Professionals guidance about palliative medicine in chronic heart failure: a mixed-method study

Professionals guidance about palliative medicine in chronic heart failure: a mixed-method study

Validation of the German version of the needs assessment tool: progressive disease-heart failure

Validity and reliability of the palliative care needs assessment tool in Japanese patients with heart failure

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