| Summary: | 碩士 === 國立臺灣大學 === 護理學研究所 === 93 === The purposes of this study were (1) to explore the health care needs and levels of needs satisfaction perceived by heart failure patients and their primary nurses, (2) to compare the differences between patients'' and nurses'' perceptions, (3) to identify the factors related to the health care needs.
This was a descriptive and cross-sectional study, using a purposive sampling method. The subjects were 72 heart failure patients and 49 nurses from a medical center and a regional teaching hospital in northern Taiwan. Four instruments were used in this study including Background Information, The Congestive Heart Failure Symptom Distress Experience Scale, Barthel’s Scale and The Heart Failure Patients’ Health Care Needs and Satisfaction Inventory.
The findings were summarized as following:
1. The levels of health care needs perceived by nurses and heart failure patients were between “important” to “very important”, and the levels of needs satisfaction were “moderate”. Health care needs were significantly related to the levels of needs satisfaction (r = 0.56, 0.48, respectively; p < 0.01).
2. Nurses overestimated patients’ needs including overall health care needs, information needs, psychosocial needs (t = 2.03, 4.37, 2.54, respectively; p < 0.05)and underestimated patients’ spiritual needs(t = -2.40; p < 0.05). On the other hand, nurses identified the levels of needs satisfaction significantly lower than patients themselves in overall health care needs, psychosocial needs(t = -2.08, -2.71, respectively; p < 0.01), physical needs and spiritual needs(t = -2.27, -3.03, respectively; p <0.05).
3. Factors related to the health care needs of heart failure patients were age, gender, NYHA classification, smoking, level of symptom distress and activities of daily living. Nurses’ age, career seniority and experiences of caring for cardiovascular patients were factors that related to the findings of needs assessment.
Based on these findings, we suggested that:
1. Nurses’ ability to assess patients’ health care needs should be improved to provide appropriate intervention.
2. Hospital in-service training programs which focused on patients’ high-important, low-satisfaction needs (e.g. management of sleep problems) should be arranged.
3. The case management program should be introduced, collaborated with nurses, to provide proper care for patients
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