Palliative Care Needs And Influencing Factors Of Patients With Advanced Lung Cancer

ObjectivesThe objectives of this study were to explore the current situation and its influencing factors of palliative care needs in patients with advanced lung cancer,so that providing information support for medical staff and evidence for making individualized palliative care program,promoting the application of palliative care in patients with advanced lung cancer.MethodsThis is a mixed research method study.The first phase was quantitative research,the second phase was qualitative research.1.Quantitative study: This was a cross-sectional descriptive study.From March to July 2022,319 patients with advanced lung cancer in a hospital in Anhui Province were selected by convenience sampling method.The General Information Questionnaire,the Problems and Needs in Palliative Care Questionnaire(PNPC-sv),Hospital Anxiety and Depression Scale(HADS)and Karnofsky Performance Status(KPS)were used.The data were analyzed statistically with Excel and SPSS26.0.2.Qualitative study: From September to December 2022,a total of 13 patients with advanced lung cancer in the department of oncology or respiratory medicine of a hospital in Anhui Province were selected by the objective sampling method for semi-structured interviews,deeply explore palliative care needs and its influencing factors in patients with advanced lung cancer,making explanation and supplements for the results of quantitative study.The data were collated and summarized by Atlas.ti and Colaizzi’s method.Results1.Quantitative study: A total of 319 questionnaires were received in this study,with an effective response rate of 91.7%.(1)The current situation of palliative care needs of patients with advanced lung cancer: The total score of palliative care needs of 319 patients with advanced lung cancer was(27.62±12.95).The top three dimensions with the highest scores were information dimension(1.59±0.71),psychological dimension(1.25±0.59)and economic dimension(1.15±0.73).The dimension with the lowest score was the dimension of daily life(0.55±0.63).(2)The status of anxiety and depression of patients with advanced lung cancer:The score of anxiety dimension of patients with advanced lung cancer was(7.13±3.92),54.9% of the patients definitely had anxiety symptoms;the score of depression dimension was(10.67±4.11),and 50.8% of the patients definitely had depressive symptoms.(3)The functional status of patients with advanced lung cancer: The score of patients’ physical function ranged from 40 to 90,with an average of(71.19 ±13.31)points,and 87.1% of the patients scored ≥ 60 points.(4)Analysis of influencing factors of palliative care needs of patients with advanced lung cancer: Multiple stepwise regression analysis showed that anxiety,KPS score,history of radiotherapy,gender,caregivers and economic burden were the influencing factors of palliative care needs in patients with advanced lung cancer(P <0.01),which could explain 55.6% variation of palliative care needs.2.Qualitative research: In this study,13 patients with advanced lung cancer were interviewed,2 themes and 13 sub-themes were extracted.Theme 1 is unmet palliative care needs,and the sub-themes include symptom management needs,disease information needs,medical communication needs,psychological and spiritual support needs,and social support needs.Theme 2 is the influencing factors of palliative care needs,including:(1)patients’ own factors: religion,gender,age;(2)disease-related factors: symptom burden,chemotherapy,knowledge of disease;(3)social support;(4)epidemic prevention and control management.ConclusionPatients with advanced lung cancer have many palliative care needs,among which the information needs are the highest.Anxiety,KPS score,history of radiotherapy,gender,caregivers and economic burden were the main influencing factors of palliative care needs.In addition,qualitative research deeply explored the patients’ experience and needs,showed that in addition to the results of quantitative research,the influencing factors of palliative care needs in patients with advanced lung cancer also including religion,chemotherapy,knowledge of disease,social support,epidemic prevention and control management.Healthcare professionals should always pay attention to nursing humanistic care in their work,provide personalized palliative care according to the needs of patients,meet their unmet palliative care needs,improve their coping ability and improve their quality of life.