Development and psychometric properties of the ‘Assessment of Burden of Chronic Conditions (ABCC) tool’ for people with chronic heart failure (CHF): a mixed methods approach

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  Figure 1. Steps and components of the Assessment of Burden of Chronic Conditions (ABCC) tool. First, the patient completes a self-reported questionnaire (the ABCC scale) at home assessing perceived burden of disease. Second, the outcomes of the ABCC scale are digitally visualised into a balloon diagram during the consultation with the healthcare provider (HCP). Each balloon symbolises a domain of perceived disease burden or lifestyle; height and colour are based on predefined cut-off points. Third, the patient and healthcare provider together decide about which domain(s) they want to talk. By clicking on a balloon, advice per domain can be requested as an in-screen pop-up. Fourth, the patient and healthcare provider formulate a personalised treatment goal to include in the individual care plan. This gives patients direction to work on their health at home until the next consultation. In preparation for the next consultation, the cycle begins again with the completion of the ABCC scale. During this consultation, current outcomes on the questionnaire appear in coloured balloons, outcomes of the previous consultation appear in grey. Visualising the differences in this way creates a monitoring…

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  Figure 2. Visualisation of the perceived burden of disease of a person with CHF. On the far left, four disease-specific domains for CHF are shown, followed by seven generic domains, ranging from physical limitations to medicines. Four lifestyle domains are on the far right. All balloons represent domain scores derived from the ABCC scale: green for a low score, orange for a moderate score and red for a high score. To follow and visualise changes over time, grey balloons illustrate the domain scores from the previous visit to the healthcare provider. In cases of comorbidities, the associated disease-specific domains will be shown to the left of the CHF domains. *Translated from the original Dutch version.