Learning Needs of Hospitalized Heart Failure Patients in Singapore

Friday, 25 July 2014

Shu Fen Ong, RN
Khoo Teck Puat Hospital, Alexandra Health Pte Ltd, Singapore, Singapore


The purpose of the study is to investigate the learning needs of hospitalized HF patients for the purpose of informing the design of educational material which is tailored for HF patients in Singapore.

 The specific objectives of the study are as follows:

(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.


Study Design:

A descriptive correlational study with questionnaire survey is used in this project.

Settings and sample:

A convenience sample is recruited from an acute tertiary hospital in Singapore. The inclusion criteria are patients who are as follows: (1) clinically diagnosed with HF, NYHA (New York Heart Association) classification I to IV; (2) are 21 years of age or older; and (3) are able to communicate in English and Chinese. The exclusion criteria covers patients with a known history of major psychiatric illness, terminal illness other than HF and impaired bilateral hearing or vision.

The sample size is determined by the number of participants that are required to maintain the statistical power for the statistical tests involved, including correlation analysis. To achieve a power of 0.80 at the 5% significance level, the minimum of 85 participants is required (Cohen, 1992).

Data collection:

A well-developed instrument, named “Heart Failure Patient Learning Needs Inventory” (HFLNI), as well as a Chinese version of it (C-HFLNI) is used to investigate the learning needs of patients with HF. A socio-demographic and clinical data sheet in both English and Chinese was developed to collect information on the socio-demographic profile and clinical data of study subjects.

The HFPLNI is an instrument modified from the Cardiac Patient Learning Needs Inventory by Wehby and Brenner (1999). The HFPLNI is a comprehensive instrument for assessing the learning needs of patients with HF, as recommended by the Agency for Health Care Policy and Research (AHCPR) in the United States (Yu et al., 2010). The reliability and validity of the scale has been established with Cronbach alpha 0.96 for the total scale and greater than 0.87 for all subscales (Wehby & Brenner, 1999). The C-HFLNI has established validity, test-retest reliability and internal consistency with a Cronbach’s α of 0.96 for the total scale and 0.77 and 0.89 for the subscales (Yu et al., 2010).

Data collection procedure:

The researchers first identify eligible subjects from the study settings. The purpose of the study is explained and a Participant Information Sheet, in either English or Chinese is provided for written reference. The potential subject are given time to consider his/her participation. Depending on their preferred spoken language, the HFPLNI / C-HFLNI questionnaire are handed to the participant to collect data on their learning needs. No identifiable information is asked or recorded in the questionnaire. The demographic information and clinical data are collected by interviewing patients and reviewing their medical charts upon agreement to participate in the research.

Data analysis:

SPSS 20.0 is used for data entry and analysis. Descriptive statistics, including frequency distribution and central tendency, are used to summarize and describe the learning needs of the subjects. Bivariate correlation or association between learning needs and the socio-demographic and clinical variables are estimated by using independent t-test or analysis of variance for nominal variables, Spearman's rho for ordinal variables and Pearson's correlation for continuous variables.


Data collection is in progress.


The research is in progress. However, the results of this study will provide practical suggestions about how educational material can be developed to meet the needs of HF patients. The development of effective educational resources will further enhance Heart Failure Management Programmes service delivery and contribute to improved health outcomes for HF patients in Singapore.