Wellisch D, Landsverk J, Guidera K, Pasnau R O, Fawzy F
Psychosom Med. 1983 Mar;45(1):11-21. doi: 10.1097/00006842-198303000-00003.
Psychological problem frequencies of very ill, homebound cancer patients were studied using an instrument entitled "Psychosocial Problem Categories for Homebound Cancer Patients." This instrument contains thirteen major categories of problems and fifty individual problems. A total of 570 patient records were obtained from two visiting nurse agencies in two different counties. Records were rated by a pair of trained raters, with level of interrater reliability being r = 0.96. Intervention frequencies by visiting health care professionals were also assessed. Percentages are based on at least one mention of problem or intervention. The five most frequent problem categories included: 1) Somatic side effects, 30% of total problems, of which pain involved 13% of total problems, 2) Patient mood disturbance, 15% of total problems, 3) Equipment problems, 8% of total problems, 4) Family relationship impairment, 7% of total problems, and 5) Cognitive impairment, 6% of total problems. The three most frequent interventions included: 1) Instructor/reinforcement to patient/family, 22% of total interventions, 2) No intervention for problem, 17% of total interventions, and 3) Counseling/emotional support, 17% of total interventions. Because the assessment instrument showed high interrater reliabilities for the two demographically dissimilar patient populations, it may be adaptable to heterogeneous populations.
使用一种名为“居家癌症患者心理社会问题分类”的工具，对病情严重、居家的癌症患者的心理问题发生频率进行了研究。该工具包含13个主要问题类别和50个具体问题。总共从两个不同县的两家上门护理机构获取了570份患者记录。记录由一对经过培训的评估人员进行评分，评估人员之间的信度水平为r = 0.96。还评估了上门医疗保健专业人员的干预频率。百分比是基于至少一次提及问题或干预得出的。五个最常见的问题类别包括：1）躯体副作用，占总问题的30%，其中疼痛占总问题的13%；2）患者情绪障碍，占总问题的15%；3）设备问题，占总问题的8%；4）家庭关系受损，占总问题的7%；5）认知障碍，占总问题的6%。三个最常见的干预措施包括：1）对患者/家庭的指导/强化，占总干预措施的22%；2）对问题不进行干预，占总干预措施的17%；3）咨询/情感支持，占总干预措施的17%。由于评估工具对两个人口统计学特征不同的患者群体显示出较高的评估人员间信度，因此它可能适用于异质人群。
