Pigott Cathie, Pollard Annabel, Thomson Kathryn, Aranda Sanchia
Supportive Care Research Group, Peter MacCallum Cancer Centre, Locked Bag 1, A'Beckett Street, Melbourne, Victoria, 8006, Australia.
Support Care Cancer. 2009 Jan;17(1):33-45. doi: 10.1007/s00520-008-0448-7. Epub 2008 May 16.
A diagnosis of cancer can have a profound impact on the physical, emotional, psychological, social and spiritual areas of a person's life. Supportive care services are directed towards this full range of issues associated with cancer. Identification of need is the first step in meeting supportive care concerns, but there is a lack of tools and processes regularly used in clinical practice. This article reports the first steps in the development of a supportive needs screening tool appropriate for use in an oncology outpatient setting.
A review of the literature was undertaken, and a draft tool developed using a process of item reduction. A small pre-test followed by a pilot test with 87 patients attending Peter MacCallum Cancer Centre, Melbourne Australia was undertaken. Evaluation to identify usability and acceptability in clinical practice included descriptive statistics to profile patient needs and referrals generated by the supportive needs screening tool (SNST), interviews with a small sample of participants and surveys completed by staff.
The SNST was developed with 41 questions, the majority requiring a yes/no response. From the tool, a total of 1,085 needs were identified (mean = 12 needs/patient). A total of 264 referrals were generated, with 72% of patients receiving at least one referral. Patients and staff reported high acceptability.
The SNST has face validity and demonstrated usability in an ambulatory care oncology stetting, as first steps in instrument development. Further testing of reliability and validity are being undertaken.
癌症诊断会对一个人的生活在身体、情感、心理、社会和精神等方面产生深远影响。支持性护理服务针对与癌症相关的所有这些问题。确定需求是解决支持性护理问题的第一步，但临床实践中缺乏经常使用的工具和流程。本文报告了开发一种适用于肿瘤门诊环境的支持性需求筛查工具的初步步骤。
进行了文献综述，并通过项目缩减过程开发了一个工具草案。随后进行了小型预测试，接着对澳大利亚墨尔本彼得·麦卡勒姆癌症中心的87名患者进行了试点测试。为确定临床实践中的可用性和可接受性而进行的评估包括描述性统计以分析患者需求以及支持性需求筛查工具（SNST）产生的转诊情况、对一小部分参与者的访谈以及工作人员完成的调查。
SNST包含41个问题，大多数问题只需回答“是”或“否”。通过该工具共确定了1085项需求（平均每位患者12项需求）。共产生了264次转诊，72%的患者至少收到了一次转诊。患者和工作人员报告了较高的可接受性。
作为工具开发的初步步骤，SNST在门诊肿瘤护理环境中具有表面效度并展示了可用性。正在对其可靠性和有效性进行进一步测试。
