| ObjectiveTo gain an in-depth understanding of the hospice care needs of endstage cancer patients,to construct a hospice care program for end-stage cancer patients,to explore its effects on the quality of life,anxiety and depression,and social support of end-stage cancer patients,and to provide a reference basis for clinical promotion of hospice care intervention.Methods1.Using the method of purposive sampling,13 cases of end-stage cancer patients in a tertiary hospital in Hunan Province from May to June 2020 were selected as the research objects.Semi structured interviews and Colaizzi phenomenological analysis were used to analyze the data,and to explore the hospice care needs of end-stage cancer patients.2.The Delphi expert consultation method was used to construct a hospice care program for end-stage cancer patients.3.Seventy-six patients diagnosed with end-stage cancer in the oncology department of a tertiary care hospital in Hunan Province from September 2020 to March 2021 were selected using a convenient sampling method and randomly divided into an intervention group and a control group using a randomized controlled trial study method.Thirty-seven cases in the intervention group received hospice care program intervention along with conventional care,while thirty-nine cases in the control group received conventional care only.Self-Rating Anxiety Scale,Self-rating Depression Scale,Social Support Rating Scale and EORTC QLQ-C30 were selected to evaluate the intervention effects of the two groups before and after the intervention,respectively.4.Excel 2019 and IBM SPSS Statistics Version 23.0 were used for data entry and statistical analysis.Statistical methods included descriptive statistics,t-test,Chi-square test,and non-parametric test.Results1.Through qualitative interviews with 13 end-stage cancer patients,five themes of physical comfort,psycho-spiritual support,social support,life and death education,and pre-will needs were distilled.2.Integrating the results of the preliminary qualitative interviews and literature review,the preliminary draft of the hospice care plan for endstage cancer patients was formed;the positivity of experts in the two rounds of Delphi expert correspondence was 87% and 100%,and the experts who gave their opinions accounted for 75% and 25%,respectively;the authority coefficients of experts were 0.875 and 0.903,respectively;the mean importance assignments ranged from 3.35 to 5.00,and the perfect score rate was between 10.0% ~100.0%;Kendall’s harmony coefficients were 0.256 and 0.302,respectively(p < 0.001);the hospice care program for end-stage cancer patients formed included 6 level 1 entries,21 level 2 entries,and 78 level 3 entries.3.After the intervention,a total of 76 end-stage cancer patients were finally enrolled.There were 5 cases of loss in the intervention group and 3 cases in the control group.Comparing the application effects of the intervention group and the control group,the overall health status,functional field scores(physical,role,emotion,cognition,social function)and social support scores of the intervention group were significantly higher than those of the control group after the intervention,with statistically significant differences(P<0.05);the symptom area scores(fatigue,nausea and vomiting,pain,shortness of breath,insomnia,loss of appetite,constipation,diarrhea),the total score of anxiety self-evaluation and the total score of depression self-evaluation were significantly lower than those of the control group,and the difference was statistically significant(P < 0.05).Conclusion1.In this study,the hospice care program for end-stage cancer patients was constructed through two rounds of expert consultation,including 6 primary entries,21 secondary entries,and 78 tertiary entries,with scientific and standardized construction methods and reliable contents,which can provide reference for carrying out hospice care practice for end-stage cancer patients.2.The hospice care program for end-stage cancer patients constructed in this study was able to improve anxiety and depression,social support and quality of life of end-stage cancer patients. |
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