Study On The Construction Of Hospice Care Strategy For Advanced Cancer Patients By 6S Model

Objective(s):Based on the 6S model,this study constructs a standard hospice care strategy for advanced cancer patients based on the hospice care needs of advanced cancer patients,looking forward to providing references for hospice care practice.Methods:Through semi-structured interviews,nurses’ perceptions of hospice nursing needs of advanced cancer patients were explored.In line with the interview results,combined with literature searches,the first draft of hospice nursing strategy for advanced cancer patients was constructed with reference to the 6S model theory and Maslow’s hierarchical needs theory;the nursing strategy was revised through expert meetings and Delphi method to improve the specific contents of the nursing strategy,and the final draft of the hospice care strategy for advanced cancer patients was developed.Results:1.Nursing needs of advanced cancer patients include 6 themes(pain control,selfimage identity,social relationship support,respect and encouragement of medical decision making,self-reconciliation,acceptance of facts and planning)and 17subthemes(pain medication,pain education,pain evaluation,timely notification and persuasion,reducing the impact of appearance changes,privacy protection,maintaining daily life,family support,nursing staff support,social system support,respecting family representative decision-making,encouraging patient participation in decision-making,safety management,evaluation life,go with the flow,ease emotions,fulfill wishes),The first draft of hospice care strategy for advanced cancer patients was formed by combining literature search and theoretical basis,including 6 first level items,17 second level items and 35 third level items.2.After the expert meeting and Delphi consultation,the hospice care strategy for advanced cancer patients was developed,including symptom management(pain management,respiratory symptom management,digestive symptom management,other symptom management,comfort care),self-image identity(guidance to help identify with changes in self-identity and appearance,reduce the negative impact of self-image,protect privacy),and social relationship support(family and friend support,medical and nursing support,and social relationship support),encouragement and respect for medical decision making(encourage patients for participation in medical decision making,respect for a family agent makes the medical decision),selfreconciliation(safety management,summing up one’ life))and acceptance of facts and planning(going with the flow,easing emotions,respecting rights and meeting wishes,family grief counseling),with 6 first level items,19 second level items and 62 third level items.The questionnaire response rates of the two rounds of Delphi consultation among 18 experts were both 95%,and expert authority coefficients Cr were 0.903 and 0.910,and Kendall’s W were 0.096 and 0.124,the mean score of all the items in the second round of consultation was > 4,and the CV of the coefficient of variation was 0-17%.Conclusion(s):In this study,the construction of hospice care strategy for advanced cancer patients is based on the 6S model theory,in line with the hospice care needs of advanced cancer patients,then revised and improved by the expert meeting method and Delphi method.The care strategy has certain scientificity and reliability,and the strategy content is comprehensive and detailed,which can provide some reference and guidance for clinical nursing practice.