Investigation And Analysis On The Supportive Care Needs Of Family Caregivers Of Patients With Lung Cancer

Objective 1.To validate the scientitificity and applicability of the Chinese version of Needs Assessment of Family Caregivers-Cancer(NAFC-C)scale for family caregivers of patients with lung cancer and provide more optional instruments for research on needs of family caregivers of patients with lung cancer.2.To investigate the status of supportive care needs and analyze the influencing factors of unmet needs for family caregivers of patients with lung cancer and provide theorietical basis for intervention study.Methods This research is a descriptive study.In the first part,according to the inclusion and exclusion criteria,a total of 179 family caregivers of inpatients with lung cancer from October 2018 to April 2019 in a top-tier hospital were investigated by convenience sampling using self-designed general information questionnaire and the Chinese version of NAFC-C scale to test its reliability and validity;In the second part,a total of 231 inpatients with lung cancer and their family caregivers from May 2019 to December 2019 in the same hospital were investigated by convenience sampling,the survey tools included self-designed general information questionnaires both for patients and their family caregivers,the verified Chinese version of NAFC-C scale,HADS,KPS.The data were input by Epi Date3.1 and analyzed by SPSS25.0 to describe the status of supportive care needs and identify the influencing factors of unmet needs for family caregivers.Results 1.The performance of the Chinese version of NAFC-C scale 1.1 Reliability The Cronbach's ? coefficient of the whole scale was 0.78,and those for each dimension ranged from 0.76 to 0.90.The test-retest reliability coefficient of the whole scale was 0.86,and those for each dimension ranged from 0.71 to 0.79.1.2 Validity Adopting the item-correlation analysis method to analyze the content validity of NAFC-C scale,the results showed that the Pearson's correlation coefficient ranged from 0.50 to 0.88(P<0.05).Using the exploratory-factor analysis method to analyze the construct validity,the results showed that the cumulative variance contribution rate of the extracted six common factors is 68.067%,which was almost consistent with the structure set of the original scale.2.The status of the supportive care needs for family caregivers of patients with lung cancer 2.1 The total score for the index of unfulfillment of needs in family caregivers of patients with lung cancer was 138.34±34.91,average score for each item was 5.12±1.29,the medical dimension ranked the first(6.64±2.85),the following were financial dimension(5.99±3.44)and psychosocial dimention(4.58±1.53),the daily activity dimension(4.08±2.17)ranked the last.2.2 The total score for the importance of needs in family caregivers of patients with lung cancer was 66.61±8.82,average score for each item was 2.47±0.33,the medical dimension ranked the first(2.83±0.67),the following were financial dimension(2.57±0.73),psychosocial dimention(2.50±0.41)and daily activity dimension(2.08±0.64).19.9%?97.3% of the family caregivers rated certain needs as important.2.3 The total score for the satisfaction of needs in family caregivers of patients with lung cancer is 55.70±9.19,average score for each item is 2.06±0.34.Ranking by the degree of unsatified,the medical dimension went the highest(2.30±0.71),then followed by the financial dimension(2.18±0.86),the daily activity dimension(1.95±0.74),and the psychosocial dimention(1.94±0.41).The incidence rate of unmet needs was 30.5%?89.8%.3.The psychologic status of patients with lung cancer The total score for the HADS was 16.92±6.00,and 8.46±2.70 for the HAS,8.46±3.70 for the HDS respectively.The incidence rate was 24.8% for anxiety and 35.8% for depression respectively among the patients with lung cancer.4.Factors influencing the unmet supportive care needs for family caregivers 4.1 Correlation factors analysis:the results showed that the gender,residence,degree of education,family income,the burden of health-care costs,physical condition,relationship with the patients,living with the patients or not,shift with others or not,total time for care,time for care per day for family caregivers;payment for treatment cost,the scores of the KPS,HAS and HDS for patients significantly correlated to the caregivers' unmet needs.4.2 Multivariate analysis:the multiple stepwise regression analysis showed that the gender,degree of education,the burden of health-care costs,shift with others or not,total time for care,time for care per day for family caregivers and the scores of the KPS,HAS,HDS for patients were the main factors influencing the regression equation of the caregivers' unmet needs.Conclusion 1.The Chinese version of NAFC-C scale has satisfactory reliability and validity based on the research finding,and can be used for the assessment for the supportive care needs of the family caregivers of patients with lung cancer.2.The family caregivers of patients with lung cancer has plenty of unmet supportive care needs,they have stronger need for medical dimension,especially for symptom management and related information.The following are financial dimension,psychosocial dimention and daily activity dimension.3.Unmet supportive care needs of family caregivers of patients with lung cancer are affected by many factors: the gender,degree of education,the burden of health-care costs,shift with others or not,total time for care,time for care per day for family caregivers and the scores of the KPS,HAS,HDS for patients are the main factors.