Development And Preliminary Application Of Supportive Care Need Scale For Urostomy Patients With Bladder Cancer

Objective:To develop a supportive care needs scale for bladder cancer patients with urostomy and test its reliability and validity,so as to provide a research tool for medical worker to assess the supportive care needs of patients with urostomy.The developed scale was initially applied in clinical practice to investigate and analyze the status quo and influencing factors of supportive care needs of bladder cancer patients with urinary stoma in China,so as to provide basis and reference for the development of personalized supportive care programs in the later stage.Method:1.Constructing the item pool of supportive care needs scale for bladder cancer patients with urostomy: To clarify the current commonly used supportive care needs scale and the current needs of bladder cancer patients with urostomy through literature review.Purposive sampling method was used to select 15 bladder cancer patients with urostomy for semi-structured interview to understand the supportive care needs of patients.To preliminarily construct the item pool of the supportive care Needs Scale for bladder cancer patients with urostomy.2.Expert consultation: 22 experts working in the fields of stoma wound care,urology nursing,oncology nursing and community nursing were selected from inside and outside the province for consultation.After comprehensive expert opinions and group discussion,the items were revised,deleted and merged to form the scale.3.Current status and influencing factors of supportive care needs of bladder cancer patients with urostomy: A total of 123 patients were selected by convenience sampling and investigated with the general information questionnaire and the formal version of the supportive Care Needs Scale for bladder cancer patients with urostomy in a hospital in jiangxi province.Independent sample t test,one-way analysis of varianceand other statistical methods were used to analyze the influencing factors of supportive care needs of patients with urostomy.4.Investigation on the current situation of supportive care needs of urostomy patients with bladder cancer: 123 patients who were treated in the ostomy wound clinic and urology department of a tertiary hospital in jiangxi Province were investigated using the convenient sampling method,using the general data questionnaire and the bladder cancer urostomy patient support care needs scale.Results:1.Preliminary determination of the item pool of the scale: through group discussion and semi-structured interviews,the item pool of the supportive care needs scale for bladder cancer patients with urostomy was preliminarily drawn up,with a total of 4 dimensions and 37 items.2.Results of expert consultation: a total of 22 experts were invited to participate in expert consultation.The recovery rates of the consultation were 100% and 90.19%,the expert authority coefficients were 0.87 and 0.90,and the Kendall’s W range was0.16～0.23(P<0.05).Furthermore,the coefficient of variation of each item was less than 0.25.After comprehensive expert opinions,the first draft of the supportive care needs scale for bladder cancer patients with urostomy was formed with 4 dimensions and 32 items.3.Re-screening items and reliability and validity test: after item analysis and factor analysis,a total of 3 items were deleted.Exploratory factor analysis was performed for the 29 items,and 6 common factors were finally extracted,and the cumulative variance contribution rate was 70.221%.Content validity of the scale: the content validity of each item ranged from 0.78 to 1.00,and the scale-level content validity index was 0.95.The Cronbach’s α of the total scale was 0.909,the Cronbach’sα of the six dimensions ranged from 0.729 to 0.937,and the split-half reliability was0.777.After screening the items of the scale again,the official version of the scale consisted of 6 dimensions and 29 items.4.Status quo and influencing factors analysis of supportive care needs of bladder cancer patients with urostomy: the total score of supportive care needs of bladder cancer patients with urostomy was(65.04±12.55),among which the average score of professional medical support needs dimension was(2.75±1.05).Information support needs had the lowest average score of(1.90±1.08).The type of main caregiver,Per capita monthly household income,complications,postoperative years and Payment methods for medical expenses were the influencing factors of supportive care needs of bladder cancer patients with urostomy(P < 0.05),43.4% variation can be explained.Conclusion:1.The Supportive Care Needs Scale for Bladder Cancer patients with urostomy developed in this study has good reliability and validity,which is suitable for medical staff to assess the supportive care needs of such patients.2.Medical staff should pay attention to the reasonable needs of bladder cancer patients with urostomy.The main influencing factors of the needs include the type of main caregivers,postoperative years,complications,per capita monthly household income and payment methods of medical expenses.Medical workers should implement personalized supportive care programs according to the actual situation of bladder cancer patients with urostomy,so as to facilitate the physical and mental health and social regression of patients and improve the quality of life of patients.