Concurrent validity and prognostic utility of the Needs Assessment Tool: Progressive Disease Heart Failure

King, Chloe; Khamis, Assem; Ross, Joy; Murtagh, Fliss E.M.; Johnson, Miriam J.; Ramsenthaler, Christina

Abstract

Context: People with advanced heart failure have supportive and palliative needs requiring systematic assessment. Objectives: We aimed to assess the validity of the Needs Assessment Tool: Progressive Disease – Heart Failure (NAT:PD-HF). Methods: Secondary analysis of routinely collected patient data from a specialist palliative care-heart disease service improvement project. NAT:PD-HF, the Integrated Palliative care Outcome Scale (IPOS), and patient and/or carer-report data were collected. Concurrent validity between NAT:PD-HF items and comparison measures (Kendall's tau; kappa); construct validity via known-group comparisons; predictive utility of NAT:PD-HF for survival (multivariable Cox hazard regression model). Results: Data from 88 patients (50% men; mean age 85; median survival 205 days; 64% left ventricular systolic dysfunction) were analyzed. Prevalence- and bias-adjusted kappa values indicated moderate agreement for physical symptom needs (k: 0.33 for patients, 0.42 for carers). Substantial agreement was observed for patient and/or carer psychological symptoms, and information needs (k ≥ 0.6). NAT:PD-HF distinguished between patients with different survival, comorbidities, functional scores, and palliative Phase of Illness with moderate to high effect sizes. NAT did not predict survival when adjusted for mortality risk score and functional status (2+ needs HR: 1.52, 95% CI: 1.01-1.74). Conclusion: The NAT:PD-HF is a valid tool for clinician assessment of physical, psychosocial, and information patient and/or carer needs.

Citation

King, C., Khamis, A., Ross, J., Murtagh, F. E., Johnson, M. J., & Ramsenthaler, C. (in press). Concurrent validity and prognostic utility of the Needs Assessment Tool: Progressive Disease Heart Failure. Journal of pain and symptom management, https://doi.org/10.1016/j.jpainsymman.2022.01.014

• Journal Article Type: Article
• Acceptance Date: Dec 18, 2021
• Online Publication Date: Jan 22, 2022
• Deposit Date: Jan 26, 2022
• Publicly Available Date: Jan 23, 2023
• Journal: Journal of Pain and Symptom Management
• Print ISSN: 0885-3924
• Electronic ISSN: 1873-6513
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1016/j.jpainsymman.2022.01.014
• Keywords: Needs assessment; Heart failure; NAT:PD-HF; Construct validity
• Public URL: https://hull-repository.worktribe.com/output/3917041