Construction Of Peer Support Intervention Program For Postoperative Patients With Gastric Cancer Based On Supportive Care Theory

ObjectiveThe study explored the current situation of supportive care needs of postoperative gastric cancer patients through a questionnaire and analyzed its influencing factors;discussed the facilitating and hindering factors for postoperative gastric cancer patients to participate in peer support activities through semi-structured interviews;and based on this,constructed a scientific,standardized and reasonable "peer support intervention program for postoperative gastric cancer patients based on supportive care theory" through the Delphi method based on the literature review.The aim of this study is to explore the methods of peer support activities for postoperative patients with gastric cancer and to help develop a rigorous peer support program,so as to provide a reference for the further application and development of peer support in postoperative supportive care for patients with gastric cancer.Methods1.Questionnaire survey: 135 postoperative gastric cancer patients hospitalized in2 third-grade class-A hospitals were surveyed by the research team’s homemade General Information Profile Questionnaire and Supportive Care Need Survey ShortForm(SCNS-SF 34)to explore their current situation of supportive care needs and to analyze the influencing factors.2.Semi-structured interview method: Following the purposive sampling method,semi-structured interviews were conducted with 12 postoperative gastric cancer patients in 1 third-grade class-A hospital on their attitudes and perceptions towards participating in peer support activities.content analysis was used to analyze the interview data.and explored the facilitating and hindering factors affecting patients’ participation in peer support activities.3.Literature review: Under the guidance of supportive care theory,combined with the results of the previous quantitative and qualitative studies,and through the review and analysis of relevant literature,the preliminary construction of the Peer Support Intervention Program for Postoperative Patients with Gastric Cancer based on Supportive Care.4.Delphi method: Determine the inclusion criteria for experts and select experts in relevant fields for consultation.After two rounds of expert consultation,finally formed the "Peer Support Intervention Program for Postoperative Gastric Cancer Patients Based on Supportive Care Theory".Results1.The total score of supportive care needs of postoperative patients with gastric cancer was(87.19±15.32),with the highest to lowest scores for each dimension being medical and information dimension needs(33.44±9.79),psychological needs(26.63±7.50),care and support needs(11.61±4.03),physical and daily living needs(10.70±3.70)and sexual needs(4.80±2.58).The highest unmet support needs were medical and information needs(64.38%),followed by psychological needs(59.70%),physical and daily living needs(45.78%),and care and support needs(41.48%)and the lowest were sexual needs(20.49%).The results of this study showed that gender,age,work status,treatment modality,chemotherapy cycle,medical payment status,and surgical modality status were factors influencing the supportive care needs of postoperative gastric cancer patients,with statistically significant differences(P<0.05).2.The results of the qualitative study showed that postoperative patients with gastric cancer were more motivated to participate in peer support activities,and the factors that facilitated patients’ participation in peer support activities were access to disease-related information support,access to emotional support,access to support for dietary and nutritional management,and support and encouragement from healthcare professionals;factors that hindered patients’ participation in peer support activities included distance and transportation limitations,distress from somatic symptoms,and interference from peer supporters.3.After two rounds of Delphi expert consultation,the "Peer Support Intervention Program for Postoperative Gastric Cancer Patients Based on Supportive Care Theory" was finally confirmed,containing 4 primary indicators,12 secondary indicators,and60 tertiary indicators.The participation rates of experts in the two rounds of consultation were 85.00% and 94.12% respectively;the authority coefficients were0.85 and 0.86 respectively;the range of Kendall’s harmony coefficients for the importance of indicators at each level was 0.107 to 0.632;the range of Kendall’s harmony coefficients for feasibility was 0.150 to 0.302,and the differences were statistically significant after the chi-square test(P<0.05),which showed that experts’ opinions The degree of coordination gradually increased;the coefficient of variation of importance and feasibility of each entry were <0.25,and the expert opinions were more concentrated.Conclusion1.The supportive care needs of postoperative gastric cancer patients were at a moderate level,with the highest rate of unmet needs in the medical and information needs dimension,followed by psychological needs and the lowest in the dimension of the sexual need.In future care work,patients’ physical,psychological and social needs should be comprehensively assessed to provide them with individualized supportive care.2.The Postoperative patients with gastric cancer are more motivated to participate in peer support activities and hope that professional institutions will carry out peer support activities to meet their needs for information,emotional and life care.3.The constructed Peer Support Intervention Program for Postoperative Gastric Cancer Patients Based on Supportive Care Theory,which contains 4 primary indicators,12 secondary indicators and 60 tertiary indicators,is scientific and feasible,and can provide guidance for peer support activities for postoperative gastric cancer patients,which is expected to meet patients’ supportive needs,improve disease coping ability and survival quality,and provide a new path for supportive care model.It is expected to improve patients’ ability to cope with their illness and quality of survival,and explore new pathways for supportive care models.