| Objective: In this study,we construct the preoperative information requirement question prompt list for early cervical cancer patients.Provide theoretical basis and a practical tool for a comprehensive,dynamic,personalized and high quality of preoperative health information as well as shared decision-making.Method: This study is composed of two parts: The first part is a qualitative study,interview outline was developed through the literature review.From January to September 2017 the patients who met the standard inclusion and exclusion criteria of early cervical cancer patients were included in by the purposive sampling methods.The consenting patients serve as interviewees.Interview recording was transcribed,content analysis,subject refinement,combined with the literature review to develop expert advisory table.The second part is the consultation phase of Delphi experts.From September to December 2017,a total of 28 experts in gynecological oncology clinical nursing,clinical medicine and other related fields were selected.E-mail and paper questionnaire two ways to conduct two rounds of consultation.After consultation,the reliability and representativeness of expert opinion test to determine the dimensions and items of the question prompt list,the formation of early cervical cancer patients question prompt list.The third part is clinical trial,on March 2018,with the convenient sampling method to select 35 early cervical cancer patients before surgery,ask the patient for each item:(I)fill the degree of difficulty;(II)can cause ambiguity;(III)the best way of expression,three questions to answer.The 35 patients with pre operative cervical cancer were able to read and understand independently.The researchers modified the items that were more consistent in the patient's trial.Results: 1.Qualitative findings: a total of 11 cervical cancer patients completed a face-to-face interview.According to the literature review 6 topics extracted,combined with semi-structured interviews were improved the specific entries every theme: including knowledge of disease information needs 14 items,for issues related to information needs 46 items,postoperative nursing information needs 16 items,7 items of daily life,prognostic information demand 6 items,psychological and social support needs 4 items.2.Delphi expert consultation results: 28 experts participated in the first round of survey,28 valid questionnaires were collected,the recovery rate was 100%,the effective rate was 100%;in the second round of survey,28 experts participated in the recovery of valid questionnaires 25,the recovery rate was 89.3%,the effective rate was 100%.In the two rounds of consultation,expert advice authority coefficient was 0.86 and 0.875.In the first round of counseling,the minimum mean value of each index is 3.03 and the maximum value is 5.0.In the second round of consultation,the minimum mean value of each index is 3.28 and the maximum is 4.96.After two investigations,Kendall's harmonic coefficients of expert opinion were 0.252,0.251 respectively.In the first and second round of expert consultation,the first grade(disease knowledge,treatment problems,postoperative care,daily life style,prognosis,psychosocial support)score was 100%.3.This study developed a preoperative question prompt list contains six dimensions,including disease knowledge,treatment problems,postoperative care,daily life style,prognosis,psychosocial support,a total of 79 questions.In the course of clinical trials,according to the opinion of the patient,the expression of the 2 items is modified without changing the semantics.Conclusion: This study fully considers the opinions of the users of the question prompt list,including doctors nurses and cervical cancer patients.The feedback provided by the experts shows the absolute affirmation and support for the concept and content of the question prompt list.Proposed cervical cancer patients in the future implicate question prompt list before the consultation with doctors and put forward their concerned issues.Medical staff provide pre-cervical cancer patients with personalized information and make shared decision-making. |
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