Abstract
BackgroundAlthough a wide range of needs assessment tools for cancer patients have been developed, no standardized and commonly accepted instruments were recommended to use in clinical care. This systematic review was conducted to assess the quality of psychometric properties of needs assessment tools among cancer patients in order to help oncology healthcare professionals select the most appropriate needs assessment tools in routine clinical practice.MethodsSearches were conducted in the electronic databases of PUBMED from 1966, CINAHL from 1960, EMBASE from 1980 and PsychINFO from 1967 as well as additional sources. The quality of psychometric properties of the recruited needs assessment tools was evaluated using the agreed quality criteria for measurement properties of health status questionnaires.ResultsThirty-seven studies which evaluated the psychometric properties of 20 needs assessment tools were identified. Internal consistency was tested in 32 studies with 9 studies indicating negative rating and 4 studies intermediate rating. Less than half of the studies (13 studies) assessed test-retest reliability, and only 4 studies reported positive rating. Content validity was the most tested psychometric property appraised in 33 studies and indicated positive rating in all the evaluated studies. Structural validity was adequately evaluated in 28 studies with 23 studies reporting intermediate rating. More than half of the studies (29 studies) tested hypothesis testing and 13 studies were rated positive. Cross-cultural validity results were obtained in 13 studies with 7 studies showing negative rating. No data was available on measurement error and criterion validity. Only one study appraised responsiveness and showed intermediate rating. The Supportive Care Needs Survey-Short Form (SCNS-SF) is the most widely used instrument for needs assessment in cancer patients. It had strong evidence for internal consistency, content validity, structural validity and hypothesis testing, and moderate evidence for reliability and cross-cultural validity. Cancer Survivors’ Unmet Needs Measure (CaSUN) reported strong or moderate evidence for internal consistency, reliability, content and structural validity, and hypothesis testing. Furthermore, Supportive Cancer Care Needs Assessment Tool for Indigenous People (SCNAT-IP) had strong evidence for content validity, and moderate evidence for internal consistency, structural validity and hypothesis testing.ConclusionsDespite several needs assessment tools exist to assess care needs in cancer patients, further improvement of already existing and promising instruments is recommended.
Highlights
[3] Throughout their disease and treatment trajectories, several cancer patients suffer from a wide range of disease- and treatment-related side effects and symptom distress, which can impair their health-related quality of life (HRQOL) and make it difficult for them to get through treatment. [4,5] In addition to prolonging life, the maintenance and improvement of HRQOL is a critically important goal of integrated and patient-centered cancer care
[7] the findings indicated that none were found to meet all the acceptable criteria for measurement properties, and none were recommended to use in clinical care
Some instruments recruited in the literature review such as Cancer Care Monitor (CCM) and Symptom and Concern Checklist (SCC) have primarily focused on assessing the prevalence and severity of symptoms, but not on the evaluation of cancer care needs
Summary
Cancer is one of the leading causes of morbidity and mortality around the whole world, with approximately 14.1 million new cancer cases, 8.2 million cancer deaths, and 32.6 million people living with cancer in 2012. [1] In 2016, cancer is the second leading cause of non-communicable disease (NCD) deaths (9.0 million or 22% of all NCD deaths) globally. [2] in 2018, there are an estimated 3.91 million new cases of cancer and 1.93 million deaths from cancer in Europe where a total population that comprises 9.0% of the world’s population. [3] Throughout their disease and treatment trajectories, several cancer patients suffer from a wide range of disease- and treatment-related side effects and symptom distress, which can impair their health-related quality of life (HRQOL) and make it difficult for them to get through treatment. [4,5] In addition to prolonging life, the maintenance and improvement of HRQOL is a critically important goal of integrated and patient-centered cancer care. [6] patientcentered care cannot be fully provided without a better assessment and understanding of patient care needs and the variables that affect them. [7] several previous studies have demonstrated that, unmet care needs were significant contributors to poor HRQOL among cancer patients. [8,9,10] it is crucial for oncology healthcare professionals to identify and manage the unmet care needs of cancer patients effectively in order to enhance and maintain their HRQOL.A rigorous and systematic needs assessment is the crucial first step in integrated and patient-centered cancer care. [7] Needs assessment addresses a comprehensive appraisal of care needs of the individuals (e.g., physical, psychological, social, spiritual, financial, information and health care needs), and can help identifying whether or not the individuals want help and provide insights into the magnitude of that need. [11] Needs assessment in cancer patients is an ongoing process which is recommended to be carried out from pre-diagnosis to cure, progressing disease or death into bereavement. [7] Accurate and effective needs assessment can assist in prioritizing care needs, allocating resources to the areas and individuals that need them most, developing more appropriate and cost effective patient care strategies, and improving HRQOL eventually. [12]regarding the needs assessment tools in cancer patients, a previous literature review conducted in 2007 has identified 15 tools which have been developed from 1984 to 2004, and has appraised and compared their validity, reliability, responsiveness and feasibility.Psychometric properties of needs assessment tools in cancer patients [7] the findings indicated that none were found to meet all the acceptable criteria for measurement properties, and none were recommended to use in clinical care. A variety of cancer-specific care needs assessment tools have been developed in recent years, there is still a lack of standardized and commonly accepted tools for a comprehensive evaluation of care needs among cancer patients in routine clinical practice. The purpose of the study was to perform a systematic review on the quality of psychometric properties of needs assessment tools among cancer patients in order to make recommendations on the most appropriate instruments for care needs assessment for cancer patients through collecting evidence from previous studies. A wide range of needs assessment tools for cancer patients have been developed, no standardized and commonly accepted instruments were recommended to use in clinical care. This systematic review was conducted to assess the quality of psychometric properties of needs assessment tools among cancer patients in order to help oncology healthcare professionals select the most appropriate needs assessment tools in routine clinical practice
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