Department of Psychology, Catholic University of Daegu, 330 Geumrak 1-Ri, Hayang-eup, Gyeongsan-si, GyeongBuk 712-702, Republic of Korea.
Support Care Cancer. 2011 Dec;19(12):1957-68. doi: 10.1007/s00520-010-1037-0. Epub 2010 Nov 14.
Needs assessment is an important step toward quality and patient-centered cancer care, as it identifies patient need, guiding evidence-based cancer care policy, and maximizing care outcome. This study reports on the development and validation of comprehensive needs assessment tool in cancer (CNAT).
The CNAT, 59-item needs assessment tool for cancer was developed and validated in a large scale multi-center survey involving 2,661 cancer patients in ten fairly distributed cancer centers throughout Korea.
To ensure content validity of the CNAT, items were derived from major needs assessment tools and input from experts and patients. Exploratory factor analysis confirmed its construct validity and identified seven factors: health care staff, psychological problems, physical symptoms, information, social and religious/spiritual support, practical support, and hospital facilities/services. Cronbach's alpha for the scale was 0.97, and for subscales, it varied from 0.80 to 0.97. Convergent validity was demonstrated by its significant association with the EQ5D. Patients with elevated stress, depressive episodes, or suicidal ideation reported a significantly higher level of psychological and overall need. Known-group validity was also supported by its ability to detect significant differences according to age, gender, education, insurance status, months since diagnosis, and non-surgical anticancer treatment. Needs differed according to SEER stage and cancer type: advanced stage and breast and lung cancer were associated with a greater level of need.
The CNAT constitutes a meaningful and valid response to the challenges of cancer care, enabling assessment of need in cancer with a comprehensive yet concise and psychometrically sound tool.
需求评估是实现高质量和以患者为中心的癌症护理的重要步骤，因为它可以确定患者的需求，指导基于证据的癌症护理政策，并最大限度地提高护理效果。本研究报告了一种综合癌症需求评估工具（CNAT）的开发和验证情况。
CNAT 是一种 59 项癌症需求评估工具，在涉及韩国 10 个分布均匀的癌症中心的 2661 名癌症患者的大规模多中心调查中进行了开发和验证。
为了确保 CNAT 的内容效度，项目源自主要的需求评估工具，并征求了专家和患者的意见。探索性因素分析证实了其结构效度，并确定了 7 个因素：医护人员、心理问题、身体症状、信息、社会和宗教/精神支持、实际支持和医院设施/服务。该量表的克朗巴赫 α 值为 0.97，子量表的范围为 0.80 至 0.97。与 EQ5D 的显著相关性证明了其具有良好的收敛效度。压力升高、抑郁发作或自杀意念的患者报告了更高水平的心理和总体需求。根据年龄、性别、教育程度、保险状况、诊断后时间和非手术抗癌治疗的不同，也支持其具有已知组别的有效性。需求因 SEER 分期和癌症类型而异：晚期和乳腺癌、肺癌与更高的需求水平相关。
CNAT 是对癌症护理挑战的有意义和有效的回应，它使用一种全面而简洁、具有心理测量学意义的工具来评估癌症患者的需求。
