1. Development, psychometric evaluation, and initial feasibility assessment of a symptom tracker for use by patients with heart failure (HFaST).
- Author
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Lewis, Eldrin F., Coles, Theresa M., Lewis, Sandy, Nelson, Lauren M., Barrett, Amy, Romano, Carla DeMuro, Stull, Donald E., Turner, Stuart J., and Chang, Chunlan G.
- Subjects
HEART failure patients ,CLINICAL trials ,HOSPITAL care ,PSYCHOMETRICS ,CAREGIVERS ,HEART failure treatment ,DIAGNOSIS of dyspnea ,COUGH diagnosis ,ARRHYTHMIA diagnosis ,EXPERIMENTAL design ,PILOT projects ,CAREGIVER attitudes ,RESEARCH ,GENERAL practitioners ,STATISTICS ,HOSPITAL emergency services ,NURSES' attitudes ,STATISTICAL reliability ,BODY weight ,RESEARCH methodology ,RESEARCH methodology evaluation ,PSYCHOLOGY of cardiac patients ,INFLAMMATION ,SELF-evaluation ,STAKEHOLDER analysis ,HEALTH outcome assessment ,INTERVIEWING ,QUANTITATIVE research ,DISCRIMINANT analysis ,PHYSICIANS' attitudes ,ACQUISITION of data ,MEDICAL care ,QUALITATIVE research ,PATIENTS' attitudes ,MULTITRAIT multimethod techniques ,DYSPNEA ,WEIGHT gain ,SEVERITY of illness index ,QUESTIONNAIRES ,COMMUNICATION ,PSYCHOLOGY of caregivers ,HOSPITAL nursing staff ,PSYCHOSOCIAL factors ,MEDICAL records ,DESCRIPTIVE statistics ,RESEARCH funding ,PATIENT-professional relations ,FATIGUE (Physiology) ,HEART failure ,SYMPTOMS ,EVALUATION - Abstract
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. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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