Development, psychometric evaluation, and initial feasibility assessment of a symptom tracker for use by patients with heart failure (HFaST)
Development, psychometric evaluation, and initial feasibility assessment of a symptom tracker for use by patients with heart failure (HFaST)
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DOI：
10.1186/s41687-019-0113-6
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发表时间：
2019-05-02
影响因子：
2.7
通讯作者：
Chang, Chunlan G.
中科院分区：
文献类型：
--
作者：
Lewis, Eldrin F.;Coles, Theresa M.;Chang, Chunlan G.
背景本研究旨在开发并提供心力衰竭 (HF) 症状追踪器 (HFaST) 的心理测量和可行性试点评估，这是一种新的患者报告工具，旨在促进常规临床护理中患者和医疗保健提供者 (HCP) 之间的沟通。 HFaST 使患者能够识别恶化的心力衰竭症状，长期目标是防止住院或急诊室就诊。方法 HFaST 是根据文献证据制定的，通过认知访谈（12 名患者/护理人员和 8 名 HCP）进行定性评估，并进行定量评估（心理测量、可行性评估）。在一项多地点非干预性美国试点研究中，对 100 名诊断为心力衰竭的个体连续 7 天进行了 HFaST。随后，医疗保健提供者完成了一项调查，评估 HFaST 在临床实践中的可行性和重要性。定性发展包括文献综述以及对患者、护理人员和 HCP 的认知访谈。使用经典测试理论方法评估 HFaST 的心理测量特性。描述性统计数据深入了解了 HCP 对在临床实践中使用 HFaST 的可行性的看法。结果 为症状追踪器开发了 40 个项目的初步集合，并根据定性阶段迭代减少到 10 个项目。 HFaST 的重测信度（加权 kappa 0.71-0.97）、区分效度和结构效度是可以接受的。 HCP 将 HFaST 评为追踪心力衰竭症状的良好 (70%) 或出色 (30%) 方法。最终保留了 6 个 HFaST 项目，涵盖疲劳、呼吸短促（3 项）、肿胀和体重快速增加的概念。结论 6 项 HFaST 是一种易于使用的工具，旨在提高患者对心力衰竭症状的认识并促进与 HCP 的沟通。未来的研究应评估 HFaST 在临床实践中的实施以及作为潜在预防住院和急诊室就诊的干预措施的有效性。
Background This study aimed to develop and provide a psychometric and feasibility pilot evaluation of the Heart Failure (HF) Symptom Tracker (HFaST), a new patient-reported tool designed to facilitate communication between patients and health care providers (HCPs) in routine clinical care. The HFaST enables patients to identify worsening HF symptoms, with a long-term goal of preventing hospitalizations or emergency room visits. Methods The HFaST was developed drawing on evidence from the literature, qualitatively with cognitive interviews (12 patient/caregiver and 8 HCPs), and evaluated quantitatively (psychometric, feasibility assessment). The HFaST was administered for 7 consecutive days to 100 individuals diagnosed with HF during a multisite, non-interventional US pilot study. Health care providers then completed a survey assessing the feasibility and importance of the HFaST in clinical practice. Qualitative development included a literature review and cognitive interviews with patients, caregivers, and HCPs. The psychometric properties of the HFaST were evaluated using classical test theory methods. Descriptive statistics provided insight into HCPs' perceptions of the feasibility of using the HFaST in clinical practice. Results A preliminary set of 40 items was developed for the symptom tracker and iteratively reduced to 10 items based on the qualitative phase. Test-retest reliability (weighted kappa 0.71-0.97), discriminating validity, and construct validity of the HFaST were acceptable. HCPs rated the HFaST as a good (70%) or excellent (30%) means of tracking HF symptoms. Six HFaST items were ultimately retained, covering concepts of fatigue, shortness of breath (3 items), swelling, and rapid weight gain. Conclusions The 6-item HFaST is an easy-to-use tool designed to raise patients' awareness of HF symptoms and facilitate communication with HCPs. Future research should evaluate HFaST implementation in clinical practice and effectiveness as an intervention to potentially prevent hospitalizations and emergency room visits.