Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster, LA1 4YG, UK.
International Observatory on End of Life Care, Faculty of Health and Medicine, Lancaster University, Lancaster, LA1 4YG, UK.
Heart Fail Rev. 2021 Jan;26(1):137-155. doi: 10.1007/s10741-020-10011-7.
Patients with heart failure have comparable illness burden and palliative care needs to those with cancer. However, few of them are offered timely palliative care. One main barrier is the difficulty in identifying those who require palliative care. Several palliative care needs-assessment/measurement tools were used to help identify these patients and assess/measure their needs, but it is not known which one is the most appropriate for this population. This review aimed to identify the most appropriate palliative care needs-assessment/measurement tools for patients with heart failure. Cochrane Library, MEDLINE Complete, AMED, PsycINFO, CINAHL Complete, EMBASE, EThOS, websites of the identified tools, and references and citations of the included studies were searched from inception to 25 June 2020. Studies were included if they evaluated palliative care needs-assessment/measurement tools for heart failure populations in terms of development, psychometrics, or palliative care patient/needs identification. Twenty-seven papers were included regarding nineteen studies, most of which were quantitative and observational. Six tools were identified and compared according to their content and context of use, development, psychometrics, and clinical applications in identifying patients with palliative care needs. Despite limited evidence, the Needs Assessment Tool: Progressive Disease - Heart Failure (NAT:PD-HF) is the most appropriate palliative care needs-assessment tool for use in heart failure populations. It covers most of the patient needs and has the best psychometric properties and evidence of identification ability and appropriateness. Psychometric testing of the tools in patients with heart failure and evaluating the tools to identify those with palliative care needs require more investigation.
心力衰竭患者的疾病负担和姑息治疗需求与癌症患者相当。然而，他们中很少有人得到及时的姑息治疗。主要障碍之一是难以确定需要姑息治疗的患者。已经使用了几种姑息治疗需求评估/测量工具来帮助识别这些患者并评估/测量他们的需求，但尚不清楚哪种工具最适合这一人群。本综述旨在确定最适合心力衰竭患者的姑息治疗需求评估/测量工具。从建库到 2020 年 6 月 25 日，检索了 Cochrane Library、MEDLINE Complete、AMED、PsycINFO、CINAHL Complete、EMBASE、EThOS、已确定工具的网站以及纳入研究的参考文献和引文。如果研究评估了心力衰竭患者姑息治疗需求评估/测量工具的开发、心理测量学或姑息治疗患者/需求识别，则将其纳入研究。有 27 篇论文涉及 19 项研究，其中大多数为定量和观察性研究。根据其内容和使用背景、开发、心理测量学以及在识别有姑息治疗需求的患者方面的临床应用，确定并比较了 6 种工具。尽管证据有限，但进展性疾病-心力衰竭需求评估工具（NAT:PD-HF）是心力衰竭患者最适合的姑息治疗需求评估工具。它涵盖了大多数患者的需求，具有最佳的心理测量学特性和识别能力及适宜性的证据。需要对心力衰竭患者使用的工具进行心理测量学测试，并评估这些工具以识别有姑息治疗需求的患者，需要进一步的研究。
