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Learning needs of hospitalized heart failure patients in Singapore:
A descriptive correlational study
S. F., Ong1; P. P. M., Foong1; J., Seah1; L., Elangovan1; S. W. C., Chan2; W., Wang2. 1Khoo Teck Puat Hospital, Alexandra
Health, Singapore; 2 Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of
Singapore, Singapore
Introduction
Literature review
Heart failure (HF) is one of the most common and deadly
cardiovascular diseases in most parts of the world (Murphy et
al., 2004), and is the most common cause of hospitalization
among older people (Bundkirchen & Schwinger, 2004).
Majority of studies that investigate the learning needs of HF patients
was conducted in Western countries (Boyde et al., 2009; Harding et al.,
2008; Wehby & Brenner, 1999).
Asian studies highlighted differences in levels of learning needs, which
suggests the influence of sociocultural differences (Kim et al., 2012; Yu
et al., 2012).
In Singapore, HF is the most common cardiac cause for
admission to hospitals (Richards et al., 2011).
Patient education is an essential component for the successful
management of HF (Yu et al., 2006).
Direct adaptation of findings from Western population in Singapore is
problematic due to significant differences in social and cultural
backgrounds.
Understanding patients’ perceived learning needs can improve
HF education intervention effectiveness (Boyde et al., 2009),
and potentially reduce HF-related hospital readmissions.
Objectives
(1) To investigate the learning needs of patient with HF in Singapore;
(2) To identify the relationship between patients’ leaning needs and
their social-demographic and clinical characteristics.
Methodology
Study Design: A descriptive correlational study Data collection
with questionnaire survey
Settings and sample: A convenience sample of
100 patients will be recruited from an acute
tertiary hospital in Singapore.
Inclusion criteria
(1) Clinically
diagnosed with HF,
NYHA class I to IV;
(2) > 18 years of
age;
(3) Able to
communicate in
English and
Mandarin.
Exclusion criteria
(1) known history of
major psychiatric
illness, terminal
illness other than
HF
(2) impaired
bilateral hearing or
vision.
Data collection procedure
Instrument:
48 items, and 8 subscales encompassing:
general HF information, psychological
factors, risk factors, medications, diet,
activity, prognosis, and signs and
symptoms.
A 5 point Likert scale is used with higher
score representing more important needs
as perceived by HF patients.
English
Chinese
(Wehby & Brenner, 1999)
(Yu et al., 2010)
1
2
• Researchers identify eligible
subjects from study settings
•Depending on participants’
preferred spoken language,
either the English or Chinese
questionnaire is used
•
3
Demographic and clinical data
are collected through
questionnaire and reviewing
participants’ medical charts.
Data analysis
Cronbach’s α 0.96
Cronbach’s α 0.96
SPSS
20.0
for total scale and
for total scale and
> 0.87 for all
0.77 and 0.89 for
 Descriptive statistics
subscales
subscales
 Bivariate correlation between learning
needs and socio-demographic and clinical
+ socio-demographic and clinical data sheet. variables.
Clinical significance
• Study findings can provide practical suggestions on
development of HF-related educational materials and enhance
HF management programs.
• Contribute to improved health outcomes for HF patients, and
reduce HF-related hospital readmissions in Singapore.
References:
Boyde, M., Tuckett, A., Peters, R., Thompson, D., Turner, C., & Stewart, S. (2009). Learning for heart failure patients (The L-HF patient study). Journal of
Clinical Nursing, 18, 2030-2039.
Bundkirchen, A., & Schwinger, R. H. G. (2004). Epidemiology and economic burden of chronic heart failure. European Heart Journal Supplements,
6(supplement D), D57-D60.
Harding, R., Selman, L., Beynon, T., Hodson, F., Coady, E., Walton, M., … Higginson, I. J. (2008). Meeting the communication and information needs of
chronic heart failure patients. Journal of Pain and Symptom Management, 36(2), 149-156.
Kim, S. S., Ahn, J. A., Kang, S. M., Kim, G., & Lee, S. (2012). Learning needs of patients with heart failure a descriptive, exploratory study. Journal of
Clinical Nursing, 22, 661-668.
Murphy, N. F., Simpson, C. R., McAlister, F. A., Stewart, S., Maclntyre, K., Kirkpatrick, M., … McMurray, J. J. V. (2004). National survey of the prevalence,
incidence, primary care burden, and treatment of heart failure in Scotland. Heart, 90, 1129-1136.
Richards, A.M., Lam, C., Wong, R.C., & Ping, C. (2011). Heart failure: A problem of our age. Annals Academy of Medicine, 40(9), 392-393.
Wehby, D., & Brenner, P. S. (1999). Perceived learning needs of patients with heart failure. Heart & Lung, 28(1), 31-40.
Yu, M., Chair, S.Y., Chan, C. W. H., & Liu, M. (2010). Testing the psychometric properties of the Chinese version of the Heart Failure Learning Needs
Inventory. Heart & Lung, 2010, 39(4), 262-274.
Yu, M., Chair, S. Y., Chan, C. W. H., Li., X., & Choi, K. C. (2012). Perceived learning needs of patients with heart failure in China: A cross-sectional
questionnaire survey. Contemporary Nurse, 41(1), 70-77.
Yu, D. S. F., Thompson, D. R., & Lee, D. T. F. (2006). Disease management programmes for older people with heart failure: crucial characteristics which
improve post-discharge outcomes. European Heart Journal, 27, 596-612.