A Health Need Satisfaction Instrument for Taiwan's single-living older people with chronic disease in the community

Aims. The aims of this study were to explore health needs and need satisfaction of Taiwan's single-living older people with chronic disease in the community, develop a culturally sensitive Health Need Satisfaction Instrument and examine the relationships between health needs and need satisfaction. Background. Until now, there has been no reliable instrument for health professionals to assess, comprehensively, health needs and needs satisfaction for Chinese single-living older people with chronic disease in the community. Design. Between-method triangulation design was used. The first phase explored the contextual content of health needs from the perspectives of a purposive sampling (n = 44) using the explorative qualitative method. The second phase developed the Health Need Satisfaction Instrument and established its reliability and validity. The final phase implemented the instrument in a cohort study (n = 110) and examined the relationship between the respective/overall health needs and need satisfaction. Results. A Health Need Satisfaction Instrument with good validity and reliability encompassing tangible, psychospiritual and informational needs was developed. A significant correlation between tangible and psychospiritual needs (r = 0.238, p < 0.05) and between tangible and informational needs (r = 0.306, p < 0.01) was found. Three types of need satisfaction were inter-related (p < 0.01). A negative correlation between global health needs and need satisfaction (r = -0.223, p < 0.05) was found. Each domain of need satisfaction was negatively correlated with that particular type of health needs (p < 0.01), except for psychospiritual need (r = 0.339, p < 0.01). A measurement model between health needs and need satisfaction was established. Conclusion. This study set a successful example of a rigorous, cross-cultural instrument development process for community-based Taiwan's single-living older people. Relevance to clinical practice. Using Health Need Satisfaction Instrument, the less satisfied multidimensional health needs of community-based Taiwan's single-living older people with chronic disease can be more accurately assessed and met.