Development Of A Postoperative Follow-up Checklist For Cervical Cancer Based On Patient Needs

Objective: Identify the unmet supportive care needs of gynecologic cancer patients,clarify the specific content of supportive care needs of postoperative cervical cancer patients,develop a postoperative cervical cancer follow-up checklist using the Delphi expert correspondence method,and standardize the content and process of post-surgical follow-up for cervical cancer patients after discharge from the hospital.Methods:(1)Qualitative studies of gynecologic cancer patients’ supportive care needs were systematically searched,CASP was selected to assess the methodological quality of the literature,and the results were integrated using thematic synthesis to capture the unmet needs of gynecologic cancer patients throughout their cancer course.(2)Descriptive qualitative research were used to understand the supportive care needs of postoperative patients with cervical cancer,and themes were refined through content analysis.(3)Two rounds of correspondence were conducted using the Delphi expert consultation method to screen expert opinions and improve the list to form the final draft of the follow-up list based on patients’ needs after cervical cancer surgery.Results:(1)In this study,11 qualitative studies were systematically integrated to generate 10 descriptive themes based on the thematic analysis method,and five analytical themes were derived: psychological support,information support,social support,disease-specific symptom management,and forms of care.(2)A total of 12 postoperative cervical cancer patients were selected for semi-structured interviews,and a total of three themes and seven sub-themes were extracted: symptom management needs,disease knowledge needs,psychological burden related to disease/treatment,psychological experience related to healthcare providers’ behavior/attitude,peer support,loved one support,and role function fulfillment needs.(3)A total of 16 experts were included in this study for expert correspondence.The positive coefficients of the experts in the two rounds of correspondence were 88.89% and 100%,respectively.The authority coefficients of expert were 0.88 and 0.89,respectively.The Kendall’s W coefficients were 0.177,0.245 and 0.179 for the first,second and third levels of the expert consultation in round 1 and 0.170,0.118 and 0.107 in round 2 respectively,and the Kendall’s W coefficients were all statistically significant(P<0.05).The final postoperative follow-up checklist for cervical cancer included four primary indicators of physical and daily life support,information support,psychological support,and social support,12 secondary indicators,and 45 tertiary indicators.Conclusion: The follow-up checklist is comprehensive in content,and reliable,scientific and practical,which can provide a scientific and standardized tool to support post-discharge follow-up of patients with cervical cancer and provide a basis for the development of individualized follow-up plans.