Investigation Of Palliative Care Needs Among Newly Diagnosed People Living With HIV In China

Background:The newly diagnosed people living with HIV always have multidimensional problems,like damaged mental health,physical and social function,and fragile interpersonal relationship.Palliative care is an effective way to support the newly diagnosed patients.However,the palliative care needs in newly diagnosed people living with HIV remain to be clarified in China.Objectives:(1)Revise and form the Problems and Needs in Palliative Care Questionnaire for HIV infected individual,then test its reliability and validity.(2)Describe the palliative care problems and needs of the newly diagnosed people living with HIV in China.Methods:A descriptive design was used in this study.(1)The first version of the questionnaire was formed based on the PNPC-sv and characteristics of HIV infectors,contents and cross-cultural adaption,and finally confirmation from 4 experts.Another 5 experts mainly engaged in the field of HIV/AIDS,nursing,and epidemiology were invited to evaluate the questionnaire's validity.Then 111 people living with HIV were selected to evaluate the questionnaire's reliability.(2)Convenient sampling was adopted from Beijing Youan Hospital and Beijing Ditan Hospital from August 2016 to April 2017.Totally 190 newly diagnosed individuals were recruited.The palliative care needs were measured by the Problems and Needs in Palliative Care Questionnaire for HIV infected individual.(3)Meanwhile,purposive sampling was used to recruit 12 individuals as participants in the interview.Colaizzi's phenomenological procedure was used to analyze the interview data.Results:(1)The Scale Content Validity Index(S-CVI)of the Problems and Needs in Palliative Care Questionnaire for HIV infected individuals was 0.964,and the Item Content Validity Index(I-CVI)were ranged from 0.8?1.0.The Cronbach'a coefficient of the "problem part" was 0.956,the dimensions' Cronbach'a coefficient were ranged from 0.756 to 0.888.The Cronbach'? coefficient of the "needs part" was 0.965 and the dimensions' Cronbach'a coefficient were ranged from 0.851 to 0.906.Exploratory factor analysis showed 6 common factors were extracted,the cumulative variance contribution rate was 75.4%,the factor loading were ranged from 0.504 to 0.879.(2)General scores of palliative care problems and needs were low.The average score of the palliative care problems was(14.73±13.55),and the average score of needs was(14.55±15.18).Scores of problems and needs of finatial and psychological dimensions were higher.(3)Five themes were extracted from the interview data,including psychological care needs,spiritual care needs,social needs,anti-discrimination needs,treatment-related needs.Conclusions:The Palliative Care Problems and Needs Questionnaire for HIV infected individuals has good content validity,structural validity and internal consistency reliability.The overall level of palliative care in the newly diagnosed people living with HIV is low,but there are more problems and higher needs in the psychological and economic aspects,and it is necessary for health care workers to take more attention.