Centre for Health Research & Psycho-oncology, School of Medicine & Public Health, The Cancer Council NSW, University of Newcastle & Hunter Medical Research Institute, Newcastle, NSW, Australia.
Psychooncology. 2010 Jul;19(7):726-33. doi: 10.1002/pon.1624.
Needs assessment is a valuable approach for determining the way health and social services allocate resources to people with cancer and their caregivers.
To assess the reliability, validity and acceptability of a Needs Assessment Tool (NAT) in a palliative care clinical setting.
Psychometric properties of the NAT were initially explored in a pilot study involving filmed simulated advanced cancer patient and caregiver consultations. Further testing was undertaken in a clinical setting to determine the inter-rater reliability, validity and feasibility of the NAT.
The results of the pilot study suggested good reliability and acceptability in a simulated setting. Further testing indicated that the patient daily living item was positively correlated with the Resource Utilisation Groups-Activities of Daily Living (r=0.74) and negatively correlated with the Australian Karnofsky Performance Scale (r=-0.84). Prevalence- and bias-adjusted kappa values also indicated adequate agreement between Palliative Care Problem Severity Score items and the patient physical item (0.48), psychological item (0.45) and caregiver well-being item (0.42).
Needs assessment not only facilitates the identification of people who have specific concerns or are dissatisfied with some aspect of their care, but also determines the person's desire for assistance and involvement with services. The NAT is a highly acceptable and efficient tool that can be used by health professionals with a range of clinical expertise to identify individuals' needs, thereby enabling a better match of interventions of specialist services more closely linked to needs.
需求评估是确定卫生和社会服务机构为癌症患者及其护理人员分配资源的方式的一种有价值的方法。
评估姑息治疗临床环境中需求评估工具(NAT)的可靠性、有效性和可接受性。
NAT 的心理测量学特性最初在一项涉及拍摄模拟晚期癌症患者和护理人员咨询的试点研究中进行了探索。进一步的测试在临床环境中进行,以确定 NAT 的评分者间可靠性、有效性和可行性。
试点研究的结果表明,在模拟环境中具有良好的可靠性和可接受性。进一步的测试表明,患者日常生活项目与资源利用组-日常生活活动(r=0.74)呈正相关,与澳大利亚卡诺夫斯基表现量表(r=-0.84)呈负相关。流行率和偏差调整的 kapp 值也表明姑息治疗问题严重程度评分项目与患者身体项目(0.48)、心理项目(0.45)和护理人员健康项目(0.42)之间有足够的一致性。
需求评估不仅有助于确定有特定问题或对护理的某些方面不满意的人,还确定了患者对援助和参与服务的愿望。NAT 是一种高度可接受和高效的工具,可由具有各种临床专业知识的卫生专业人员使用,以确定个人的需求,从而更好地匹配更紧密地与需求相关的专科服务的干预措施。