| Objective:Whether the demand is satisfied or not affects the overall health and quality of life of breast cancer patients.The research aimed at qualitative research based on the real needs of patients with different stages of breast cancer,and developed assessment tools and intervention plans that could reflect the real needs of breast cancer patients,and evaluated their impact on the health outcomes of breast cancer patients,so as to provide scientific basis for future breast cancer and other cancer patients' health managementMethod:Adopting the sequential exploratory design of "quality+quantity+quantity" in the mixed research design method,which is divided into three parts,as follows 1.Qualitative research on the needs experience of breast cancer patientsSemi-structured interviews with 20 breast cancer patients were conducted using qualitative research methods.The Colaizzi phenomenological seven-step analysis method was combined with the Nvivo10 software to analyze and sort out the interview results.A pool of scale entries on breast cancer patient needs was made based on exploring breast cancer patients' needs,the theme of needs,and the content of core needs2.Development and suitability evaluation of requirement scale for breast cancer patients(1)The item pool of the needs scale for breast cancer patients was revised through group discussion,and Delphi expert consultation was adopted to hire 15 relevant experts to participate in the simplification of the scale and form the needs scale for breast cancer patients(2)Two large sample surveys were conducted in this study.313 breast cancer patient requirement scales were collected for exploratory factor analysis,and revised the breast cancer patients' requirement scale;confirmatory factor analysis was performed on 419 breast cancer patients' requirement scale to test the stability of the factor structure of the scale to improve the breast cancer patients' needs scale.Data are input,collated and analyzed using Excel,SPSS 26.0 and AMOS 26.0 software.The breast cancer patient requirement scale explores the general demographic differences in breast cancer patients' needs through one-way analysis of variance and lays the foundation for follow-up demand intervention-related content3.Effectiveness evaluation of needs intervention for breast cancer patientsAccording to the results of qualitative research and the analysis of demand influencing factors,the intervention plan was made.The 6-month non-randomized concurrent controlled trial was conducted on 77 breast cancer patients to test the breast cancer patient demand scale's applicability using the breast cancer patient demand scale.A total of 77 subjects were included in the study,there were 38 cases in the intervention group and 39 cases in the control group.During the experiment,the control group was given routine care,and the intervention group was additionally given personalized demand intervention measures according to the stage demand characteristics of patients.The clinical indicators,needs,disease perception,self-management efficacy,and quality of life of the two groups before and after the intervention were evaluated.Data were entered,sorted and analyzed by Excel and SPSS 26.0 software.The statistical methods include descriptive analysis,cross card square test,independent sample t test and paired sample t test.Results:1.Results of qualitative research on the needs of breast cancer patientsWe summarized the following 3 demand categories,6 demand themes,and 53 sub-themes through the transcription and coding,concept refinement,and topic excerpts of interview data of 20 breast cancer patients(1)Disease information needs(24):?Treatment information(14),?Rehabilitation information(10);(2)Psychological needs(15):?Emotional needs(8),?Cognitive needs(7);(3)Social needs(14):?Seeking hope(9),?Self-realization(5)This is the initial item pool for this study2.Compilation results of the breast cancer patient demand scale(1)The effective recovery rates of the two rounds of expert consultation questionnaires were both 100%,the expert authority coefficients were 0.893 and 0.905,and the expert opinion coordination coefficients were 0.376 and 0.419,respectively.The breast cancer patient demand scale form included 3 first-level indicators,6 second-level indicators,and 43 third-level indicators(2)Each item of the breast cancer patient needs scale was well suited.The exploratory factor analysis extracted 6 common factors,and the cumulative variance contribution rate was 62.123%The scale is consistent with the Chinese version of the Concise Scale for Unmet Needs of Cancer Patients(SF-SUNS-C)The correlation validity of the criterion is promising,the Cronbach's a coefficient of the scale is 0.959,the Cronbach's ? coefficient of each dimension is 0.789?0.897,the test-retest reliability is 0.937,and the test-retest reliability of each dimension is 0.743?0.890;In the confirmatory factor analysis,the scale factor structure is stable,all model adaptation indicators are within the ideal standard range,?2/df<3,the RMSEA value is less than 0.1,and the GFI,CFI,NFI,and IFI values are all greater than 0.9.The standardized path coefficient of each item is 0.62?0.87,the correlation coefficient between dimensions is 0.31?0.50,and the scale's internal structure validity is promising.The revised breast cancer patient demand scale includes 3 first-level indicators,6 second-level indicators,and 40 third-level indicators.The Cronbach's ? coefficient of the scale is 0.943,and the Cronbach's ? coefficient of each dimension is 0.828?0.934.There were statistically significant differences in the needs of breast cancer patients of different ages,education levels,treatment stages,and metastasis(P<0.05)3.Applicability evaluation results of the breast cancer patient demand scaleThe indexes of the two groups before and after the intervention were significantly improved,with statistical difference(P<0.05).In the comparison and analysis of the differences of health outcomes between the two groups before and after the intervention,in addition to the clinical indicators of limb lymph node edema,other indicators include:clinical indicators(shoulder range of motion,nausea and vomiting,sleep quality,pain degree),disease perception,self-management effect,quality of life,demand degree,the differences of the intervention group before and after the intervention were significantly higher than those of the control group,The differences were statistically significant(P<0.05)Conclusion:(1)Breast cancer patients have different levels of needs for disease information,psychology,and society at different stages of the disease,and they are diversified and individualized;(2)The newly developed requirement scale for breast cancer patients was considered reliable and effective,and it can be used to measure the needs of breast cancer patients at different stages;(3)It is an effective intervention method to evaluate patients' needs using the newly developed demand scale and provided personalized care for them.It showed a certain intervention effect on clinical indicators,disease perception,self-management efficiency,demand satisfaction,and quality of life on these patients,which remind us of the significance of integrating demand intervention at different stages of the disease into routine care. |
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