Fang Chun-Kai, Pi Shih-Hsuan, Li In-Fun
Hospice and Palliative Care Center and Department of Psychiatry, MacKay Memorial Hospital, New Taipei, Taiwan.
Department of Thanatology and Health Counseling, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
J Multidiscip Healthc. 2025 Jun 24;18:3647-3671. doi: 10.2147/JMDH.S520128. eCollection 2025.
Holistic care emphasizes an integrated approach addressing physical, psychological, social, and spiritual needs, yet validated assessment tools from diverse perspectives remain limited.
To develop and validate three holistic care assessment tools: the Holistic Care Quality Assessment Scale - Patient (HCQAS-P), Family (HCQAS-F), and the Holistic Care Knowledge Assessment Scale (HCKAS) for professionals.
A mixed-methods design included qualitative interviews and a cross-sectional survey at two Taiwanese hospitals. Psychometric analyses were conducted on responses from 1,017 participants: 321 patients, 298 family members, and 398 professionals.
Qualitative findings identified five core holistic care themes. A total of 1,017 participants completed the quantitative study, including patients (n = 321), family members (n = 298), and healthcare professionals (n = 398). HCQAS-P and HCQAS-F showed high internal consistency (Cronbach's α > 0.92); HCKAS revealed a four-factor structure (institutional, competence, effectiveness, cost). Holistic care quality positively correlated with shared decision-making (γ = 0.542) and good death perceptions (γ = 0.250), and negatively with demoralization (γ = -0.246) and distress (γ = -0.184). Providers scored lowest in spiritual and social care.
The validated tools offer a comprehensive assessment framework for holistic care. Findings highlight the value of shared decision-making and the need to strengthen training in non-physical care aspects.
整体护理强调采用综合方法来满足身体、心理、社会和精神需求，但来自不同视角的经过验证的评估工具仍然有限。
开发并验证三种整体护理评估工具：针对患者的整体护理质量评估量表（HCQAS-P）、针对家属的整体护理质量评估量表（HCQAS-F）以及针对专业人员的整体护理知识评估量表（HCKAS）。
采用混合方法设计，包括在两家台湾医院进行定性访谈和横断面调查。对1017名参与者的回答进行了心理测量分析，其中包括321名患者、298名家属和398名专业人员。
定性研究结果确定了五个核心整体护理主题。共有1017名参与者完成了定量研究，包括患者（n = 321）、家属（n = 298）和医疗保健专业人员（n = 398）。HCQAS-P和HCQAS-F显示出较高的内部一致性（Cronbach's α>0.92）；HCKAS呈现出四因素结构（机构、能力、效果、成本）。整体护理质量与共同决策（γ = 0.542）和良好的死亡观念（γ = 0.250）呈正相关，与士气低落（γ = -0.246）和痛苦（γ = -0.184）呈负相关。提供者在精神和社会护理方面得分最低。
经过验证的工具为整体护理提供了一个全面的评估框架。研究结果突出了共同决策的价值以及加强非身体护理方面培训的必要性。
