The need and attributes of home care services among older patients with chronic heart failure: a descriptive cross-sectional study

OBJECTIVE: The care needs of heart failure patients are complex, and the core needs have not yet been fully identified. This study used the Kano model as a framework to explore the home-care need preferences of older patients with chronic heart failure. METHODS: This study was conducted across six community hospitals from October 2024 to March 2025, including 258 older patients with CHF. A convenient sampling method was used to recruit participants, who completed a questionnaire designed based on the Kano model to assess their needs for home care service. Kano analysis was applied to identify and assess the needs and attributes of these patients. RESULTS: Among the 20 items analyzed, seven items (35.0%) were classified as must-be attributes, primarily related to the management of physical symptoms and medication intake, and self-care skills. Seven items (35.0%) were identified as one dimensional attribute, mainly concerning the sleep quality and rest, family empathy and care, prevention and management of disease worsening, and follow-up services. Six items (30.0%) were attractive attributes, focusing on the relief of appetite loss and constipation, the alleviation of emotional distress, and increased social contact. The Matrix diagram revealed that six needs were predominant Predominance Area I, six in Improving Area II, eight in Reserving Area IV. CONCLUSIONS: The home care needs of older patients with CHF were diverse. Kano model analysis aided medical staff in developing a deeper understanding of these needs, categorizing them into one-dimensional, attractive, and must-be attributes.