Primary Development And Application Of Supportive Care Needs Scale In Patient With Cancerous Wounds

ObjectiveTo develop the supportive care needs scale in patients with cancerous wounds and test its reliability and validity,to provide a reliable measurement tool for assessing the supportive care needs in patients with cancerous wounds in China;to use the scale and investigate the current situation of supportive care needs in patients with cancerous wounds and its influencing factors,and provide reference for nurses to carry out targeted supportive care in the patients with cancerous wounds.Methods(1)The dimensions and their items of the scale were initially drawn up by literature analysis and patient interview.It was revised by Delphi expert consultation,the items were screened by item analysis,and the reliability and validity of the scale were tested to determine the items of the scale in patients with cancerous wounds.(2)A total of 105 patients with cancerous wounds from 3 grade A hospitals in Changsha and Chongqing were selected by convenient sampling.The patients with cancerous wounds were investigated with“sociodemographic data questionnaire”,“cancerous wounds assessment tool”,and“malignant cancerous supportive care needs scale”.Univariate analysis and multiple stepwise regression were used to analyze the influencing factors of supportive care needs in patients with cancerous wounds.Results(1)The scale developed through literature analysis and interviews inclued 5 dimensions and 42 items.The effective recovery rate of the two rounds was 85%and 100%.The authority coefficient of the two rounds of experts was 0.88,The variation coefficients of entries in the two rounds were respectively 0.00~0.24 and 0.00~0.23,and Kendall's W value respectively was 0.359 and 0.313(P<0.05).The scale was revised and included 26 items in 4 dimensions by two rounds of expert consultation.Finally the scale of“supportive care needs scale in patients with cancerous wounds”was determined by screening items which had15 items and 4 dimensions.The Cronbach's?coefficient of the total score of the scale was 0.886,the Cronbach's?coefficient of each dimension was between 0.792 and 0.876.Spearman-Brown coefficient was 0.774.Repeated measurements were conducted on 30 patients at one-week intervals,and the results showed that the retest reliability coefficient was0.711(P<0.05).The correlation coefficient between supportive care needs and the total score of SCNS-SF34 in patients with cancerous wounds was0.438(P<0.01).The results of two exploratory factor analyses showed that four common factors were extracted,which contained 15 entries and explained 72.137%of the total variation.The I-CVI was 0.83~1.00 and the S-CVI was 0.94.(2)The results of cross-sectional survey showed that the total score of supportive care needs in 105 patients with cancerous wounds was(3.21±0.46)(the total score was 5).The scores of each dimension in order from high to low respectively were psychological needs(3.48±0.89),health information needs(3.41±0.74),physiological needs(3.03±0.76),and social support needs(2.81±0.43).The results of t test,univariate analysis of variance,multiple linear stepwise regression analysis(?_?=0.05,?_?=0.10)showed that the volume of exudate,odor,and bleeding entered the regression equation of the physiological needs dimension of supportive care needs in patients with cancerous wounds,which could explain 75.2%of the total variation of physiological needs dimension.Whether the primary tumor was transferred into the regression equation of the psychological demand dimension of supportive care needs in patients with cancerous wounds,which could can explain 9.8%of the total variation of the psychological needs dimension.Level of education,long-term residence,whether the wound was painful or not,edema entered the regression equation of the health information needs dimension of supportive care needs in patients with cancerous wounds,which could explain 29.1%of the total variation of the health information needs dimension.Conclusions(1)The scale of“supportive care needs scale in patients with cancerous”wounds developed had good reliability and validity,it could be used to measure the supportive care needs in patients with cancerous wounds in China.(2)The scores of supportive care needs in patients with cancerous wounds were the middle level,and the unmet rate was higher.The main influencing factors for the physiological needs,psychological needs,health information needs of patients with cancerous wounds in supportive care needs are respectively the amount of exudate,odor and bleeding;whether the primary tumor is metastatic;level of education,long-term residence,whether the wound is painful or not and edema.