Development Of The Index System Of Evaluation Of The Terminally Ill Cancer Patients' Needs And Clinical Primary Application

Aim: An instrument of assessing the terminally ill cancer patient' needs was supply for clinical nurses by developing index system of evaluation of the terminally ill cancer patient' needs to improve theirs ability of evaluating the terminally ill cancer patient' needs. Methods: 1. Item generation : 甌he items of evaluation system were collected by literature search, seeking advices from two doctors, two nurses, three terminally ill cancer inpatients and three cancer patients in convalescent period. ㏕he items of evaluation system were elected with Delphi method by two experts panels, semi-structured interviewing four terminal ill cancer patients and twenty pre-interview terminal ill cancer patients.2. Clinical primary application of the index system of evaluation of the terminally ill cancer patient' needs. Prevalence survey of physiological, psychological, social needs and spirit support of 96terminally ill cancer patients was conducted in 2 hospitals in xi'an. Validity, reliability and feasibility of the index system of evaluation of the terminally ill cancer patients' need were estimated by statistics according to data. Results:1. The evaluating system of the terminally ill cancer patients' needs was built which consists of 3 grade indexs, there are 4 items in grade 1, 12 items in grade 2, 41 items in grade 3.We use 4 ranks to score them. High degree of needs that has 3 grades (high, middle, low).2. The index system of evaluation of the terminally ill cancer patients' needs have satisfactory validity and reliability. The questionnaire's response rate of was 98%, test-retest was 87.5% and completion rate was 97.96%. These indicated this questionnaire was feasible to use. Total Pearson's correlation coefficient was 0.827. Pearson's correlation coefficient of physiological, psychological, social and spiritual support was 0.823, 0.636, 0.796, and 0.875, respectively. It explained test-retest reliability. Cronbach's a Coefficient of physiological, psychological, social and spiritual support was 0.7219, 0.6412, 0.7502, and 0.8275, respectively. It represent inter-item consistency. 12 principal components with eigenvalue > 1 were extracted by principal component analysis and varimax orthogonal rotation methods. Its cumulative was 71.81%. These 12 principal components including physiological, psychological, social and spiritual support domains. Itindicated satisfactory construct -related validity. 3. The need degree of majority of 96 terminally ill cancer patients was middle or high degree. It consists of 37.4% high need degree, 39.6% middle need degree and 22.9% low need degree, respectively. Psychological, social and spiritual support for terminally ill cancer patients was high than physiological support for them. The rate of patients needs the high psychological, social, spiritual and physiological support were 54.2%, 50.2%, 62.5% and 10.4%, respectively.The need degree of terminally ill cancer patients was ranked according to the mean of every item. From range 1 to range 17 were high need degree. These 5 items (from range 1 to range 5) were high need degree (the need for caring of family member; the need for contributing to family; the need for knowing inspection results; the need for companioning with family member; the need for knowing curative effect). These 15 items (from range 18 to range 33) were middle need degree. These 7 items (from range 34 to range 41) were low need degree.According to t test and A one-way analysis of variance (ANOVA) test, sex, age, marriage, educational history and religion did not influence the need degree of terminally ill cancer patients. Self-care ability was negative correlation with physiological need (r=-0.371 , P =0.000) . The need degree was high when Self-care ability was low. When the patient was in hospital fist time, he need high psychological support. Conclusion: To develop index system of evaluation of the terminallyill cancer patient' needs successfully. This system has satisfactory validity an...