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Health Needs Instrument for hospitalized single-living Taiwanese elders with heart disease: triangulation research design

Author:
Shaw-Nin Shih   Meei-Ling Gau   Chi-Hui Kao Lo   Fu-Jin Shih  


Issue Date:
2005


Abstract(summary):

Aim.  The aims of this study were (a) to explore the health needs of hospitalized Taiwanese older people with heart disease who live alone in the community; (b) to develop an instrument to assess their health needs and (c) to examine relationships among their health needs.

Design.  Three phases were involved in this between-method triangulation design.

Methods.  The first phase explored the contextual content of the health needs from the perspectives of a purposive sampling of 34 subjects by the use of an explorative qualitative method. The second phase developed the Health Needs Instrument (HNI) and established its reliability and validity. The last phase implemented the instrument in a cohort and examined their appraisals of each type of health need as well as the relationships among different types of health needs.

Results.  The HNI encompasses the following five types of health needs: help in managing tangible things, psychological support, medical support, obtaining health information and participation in decision-making. In the last phase, a purposive sample of 54 subjects (48 men and 6 women) with an average age of 75·3 years was obtained. Subjects’ health needs were ranked as obtaining health information (100%), participation in decision-making (96%), managing tangible issues (87%), medical support (86%) and psychological support (67%). Detailed items for each type of health need were revealed. By examining the relationship between their health needs, the psychological needs in confronting the subjects’ physical discomfort had a significant correlation with medical support (r = 0·469, P < 0·01), with tangible needs after surgery or an invasive examination (r = 0·460, P < 0·01), with informational needs (r = 0·393, P = 0·034) and with tangible needs of maintaining daily living activities during the hospitalization period (r = 0·290, P = 0·034). The need for tangible help in maintaining daily living activities during the hospitalization period was significantly correlated with the need for medical support (r = 0·341, P = 0·012), with help in managing admissions and discharge procedures (r = 0·374, P = 0·05) and with help after an invasive examination or in the postsurgery period (r = 0·334, P = 0·013).

Conclusion.  Finally, a conceptual framework was developed to depict this phenomenon. With the help of this HNI, both Eastern and Western health care providers can be empowered to detect the complex health needs of this particular population earlier and more accurately in order to promote their well-being as well as their health-related quality of life.

Relevance to clinical practice.  Empowering nurse clinicians to assess health needs of hospitalized single-living Taiwanese elders with heart disease.



Page:
1210-1222


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