scholarly journals Assessing unmet needs in advanced cancer patients: a systematic review of the development, content, and quality of available instruments

2021 ◽  
Author(s):  
Ben Rimmer ◽  
Lisa Crowe ◽  
Adam Todd ◽  
Linda Sharp
Keyword(s):  
Cancer Patients ◽  
Advanced Cancer ◽  
Unmet Needs ◽  
Unmet Need ◽  
Measurement Properties ◽  
Psychosocial Needs ◽  
Measurement Instruments ◽  
Advanced Cancer Patients ◽  
Health Measurement ◽  
Care Needs

Abstract Purpose Advances in treatment, including biological and precision therapies, mean that more people are living with advanced cancer. Supportive care needs likely change across the cancer journey. We systematically identified instruments available to assess unmet needs of advanced cancer patients and evaluated their development, content, and quality. Methods Systematic searches of MEDLINE, CINAHL, Embase, PubMed, and PsycINFO were performed from inception to 11 January 2021. Independent reviewers screened for eligibility. Data was abstracted on instrument characteristics, development, and content. Quality appraisal included methodological and quality assessment, GRADE, feasibility, and interpretability, following consensus-based standards for the selection of health measurement instruments (COSMIN) guidelines. Results Thirty studies reporting 24 instruments were identified. These were developed for general palliative patients (n = 2 instruments), advanced cancer (n = 8), and cancer irrespective of stage (n = 14). None focused on patients using biological or precision therapies. The most common item generation and reduction techniques were amending an existing instrument (n = 11 instruments) and factor analysis (n = 8), respectively. All instruments mapped to ≥ 5 of 11 unmet need dimensions, with Problems and Needs in Palliative Care (PNPC) and Psychosocial Needs Inventory (PNI) covering all 11. No instrument reported all of the COSMIN measurement properties, and methodological quality was variable. Conclusions Many instruments are available to assess unmet needs in advanced cancer. There is extensive heterogeneity in their development, content, and quality. Implications for Cancer Survivors Given the growth of precision and biological therapies, research needs to explore how these instruments perform in capturing the needs of people using such therapies.

Palliative Referrals in Advanced Cancer Patients: Utilizing the Supportive and Palliative Care Indicators Tool and Rothman Index

2021 ◽  
pp. 104990912110178
Author(s):  
Abigail Sy Chan ◽  
Amit Rout ◽  
Christopher R. D.’Adamo ◽  
Irina Lev ◽  
Amy Yu ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Length Of Hospital Stay ◽  
Inpatient Setting ◽  
Advanced Cancer Patients ◽  
Care Needs ◽  
Early Palliative Care ◽  
Code Status ◽  
Palliative Care Needs

Background: Timely identification of palliative care needs can reduce hospitalizations and improve quality of life. The Supportive & Palliative Care Indicators Tool (SPICT) identifies patients with advanced medical conditions who may need special care planning. The Rothman Index (RI) detects patients at high risk of acutely decompensating in the inpatient setting. SPICT and RI among cancer patients were utilized in this study to evaluate their potential roles in palliative care referrals. Methods: Advanced cancer patients admitted to an institution in Baltimore, Maryland in 2019 were retrospectively reviewed. Patient demographics, length of hospital stay (LOS), palliative care referrals, RI scores, and SPICT scores were obtained. Patients were divided into SPICT positive or negative and RI > 60 or RI < 60.Unpaired t-tests and chi-square tests were utilized to determine the associations between SPICT and RI and early palliative care needs and mortality. Results: 227 patients were included, with a mean age of 68 years, 63% Black, 59% female, with the majority having lung and GI malignancies. Sixty percent were SPICT +, 21% had RI < 60. SPICT + patients were more likely to have RI < 60 (p = 0.001). SPICT + and RI < 60 patients were more likely to have longer LOS, change in code status, more palliative/hospice referrals, and increased mortality (p <0.05). Conclusions: SPICT and RI are valuable tools in predicting mortality and palliative/hospice care referrals. These can also be utilized to initiate early palliative and goals of care discussions in patients with advanced cancer.

scholarly journals Palliative Care Needs of Advanced Cancer Patients in the Emergency Department (S767)

2018 ◽  
Vol 55 (2) ◽  
pp. 693
Author(s):  
Isabelle Marcelin ◽  
Caroline McNaughton ◽  
Nicole Tang ◽  
Jeffrey Caterino ◽  
Corita Grudzen
Keyword(s):  
Emergency Department ◽  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Advanced Cancer Patients ◽  
Care Needs ◽  
Palliative Care Needs

Unmet spiritual care needs impact emotional and spiritual well-being in advanced cancer patients

2011 ◽  
Vol 20 (10) ◽  
pp. 2269-2276 ◽  
Author(s):  
Michelle J. Pearce ◽  
April D. Coan ◽  
James E. Herndon ◽  
Harold G. Koenig ◽  
Amy P. Abernethy
Keyword(s):  
Cancer Patients ◽  
Advanced Cancer ◽  
Spiritual Care ◽  
Well Being ◽  
Advanced Cancer Patients ◽  
Care Needs ◽  
Spiritual Well Being

Unmet supportive care needs and determinants among cancer patients treated at University of Gondar Specialized Hospital, Northwest Ethiopia: A prospective cross-sectional study

2020 ◽  
pp. 107815522097103
Author(s):  
Begashaw Melaku Gebresillassie ◽  
Asnakew Achaw Ayele ◽  
Tadesse Melaku Abegaz
Keyword(s):  
Supportive Care ◽  
Cancer Patients ◽  
Unmet Needs ◽  
Unmet Need ◽  
Cross Sectional Study ◽  
Supportive Care Needs ◽  
Care Needs ◽  
Cross Sectional ◽  
Predicting Factors ◽  
Specialized Hospital

Background Assessment of supportive care needs is an important requirement to plan supportive care intervention. This study aimed to assess the unmet supportive care needs of cancer patients treated at the University of Gondar Specialized Hospital, Ethiopia. Methods A prospective cross-sectional study was conducted from January 1, 2017 to August 30, 2017. Adult (18 years and greater) cancer patients and those who were receiving therapy were included. The 34-Item short-form Supportive Care Needs Survey(SCNS-SF34) tool was used to assess unmet needs. The data collected were analyzed using SPSS version-21. Results A total of 150 interview guides were included in the analysis (97.4% of response rate). In the majority of 65(43.3%) the participants, the disease was metastasized even though they have undergone surgery 78 (52%). The overall mean score level of unmet need for cancer care was 3.49. The highest unmet need mean score was reported from the health system and information need domain. A significant unmet need difference concerning different need domain was found in sex, age, residence, occupation status, and monthly income. Sex and residence were found to be independent predicting factors for unmet supportive care needs. Conclusion The overall level of unmet need was high. A significant unmet need difference was found in sex, age, residence, occupation status, and monthly income. Sex and residence were found to be independent predicting factors. Hence, professionals working in the oncology unit should be aware of unmet needs and expect changes over time. Certain programs and services to address the identified unmet needs should be urgently provided.

Is there an unmet need for palliative care in cancer patients admitted to hospital?

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 123-123
Author(s):  
Xia Zhu ◽  
Patricia Neo ◽  
Tan Ying Peh ◽  
Zhi Zhen Xu ◽  
Alethea Yee ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Metastatic Cancer ◽  
Functional Decline ◽  
Unmet Need ◽  
Unplanned Readmission ◽  
Advanced Cancer Patients ◽  
Patient Admissions ◽  
Unplanned Admissions

123 Background: Cancer patients who are admitted to hospital often have symptom problems and progressive functional decline, and may benefit from palliative care (PC) input. The aim of this study was to determine the profile of patients admitted under Lung and Gastrointestinal (GI) oncology teams (as their cohorts of admitted patients probably have more symptom problems) and whether they are being referred for PC input. Methods: Patients admitted from 1 March 2015 to 31 March 2015 were included. The following were recorded: primary site of tumor and whether it was metastatic, whether the admission was planned or unplanned, referral for PC input, outcome of admission and unplanned readmission within 7 days and 30 days. Results: See table below. Conclusions: Although 84% of patient admissions had metastatic cancer and 82% were unplanned admissions, only 21% were referred for PC input. This represents a missed opportunity for PC input, which has been shown to improve outcomes in patients with advanced cancer. However, if all advanced cancer patients who had an unplanned hospital admission were referred for PC, there would be a large increase from the current workload of the PC team. Hence, there is a need to pilot a novel model of PC provision, perhaps one in which a PC healthcare professional joins the oncology team to provide integrated palliative oncology care. [Table: see text]

Validity and Reliability of the Family Inventory of Needs (FIN): Measuring the Care Needs of Families of Advanced Cancer Patients

1995 ◽  
Vol 3 (2) ◽  
pp. 109-126 ◽  
Author(s):  
Linda J. Kristjanson ◽  
Jan Atwood ◽  
Lesley F. Degner
Keyword(s):  
Construct Validity ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Internal Consistency ◽  
Family Members ◽  
Validity And Reliability ◽  
Alpha Coefficient ◽  
Advanced Cancer Patients ◽  
Care Needs ◽  
The Family

Two studies balanced qualitative and quantitative data to provide evidence of satisfactory validity and reliability of the Family Inventory of Needs (FIN). The FIN is designed to measure the importance of care needs of families of advanced cancer patients (FIN-Importance of Care Needs subscale) and the extent to which families perceive that their care needs have been met (FINFulfillment of Care Needs subscale). The first study involved development of the instrument and testing for clarity, apparent internal consistency (nonquantitative assessment of homogeneity of content), and content validity using a panel of six experts (family members of advanced cancer patients). The FIN met or exceeded the preset criteria specified used in this phase of testing. The second study of the project used 109 family members of advanced cancer patients from three hospice programs to test the FIN for internal consistency and construct validity. Internal consistency of the FIN-Importance of Care Needs subscale as measured by Cronbach’s alpha coefficient was .83 without redundancy. Construct analysis was assessed using factor analysis techniques. An inability to extract a substantively meaningful minimum number of factors, together with the fact that a theta reliability coefficient of .85 was obtained (only .02 higher than the alpha coefficient), suggested that the items were parallel supporting the conclusion that the subscale is unidimensional. Support for the construct validity of the FINImportance of Care Needs subscale was also obtained using predictive modeling. The internal structure of the FIN-Fulfillment of Care Needs subscale was assessed using cluster analysis. Results suggested that the subscale is a unidimensional one. Overall, the FIN met the preset reliability and validity criteria providing promising evidence for the instrument’s sound psychometric properties for use in research and clinical settings.

scholarly journals Quality of life among advanced cancer patients in Vietnam: a multicenter cross-sectional study

2021 ◽  
Author(s):  
Bui Thanh Huyen ◽  
Pham Thi Van Anh ◽  
Le Dai Duong ◽  
Than Ha Ngoc The ◽  
Ping Guo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Discriminant Validity ◽  
Correct Prediction ◽  
Advanced Cancer Patients ◽  
Care Needs ◽  
Chi Square

Abstract Purpose Cancer is a leading cause of death in Vietnam. To maximize quality of life (QOL) at the end of life, valid and clinically useful instruments are needed to assess palliative care needs and the effectiveness of palliative care interventions. Methods We aimed to (i) determine psychometric properties of the Vietnamese version of the WHO abbreviated quality of life scale (WHOQOL-BREFVN) among advanced cancer patients, (ii) measure HR-QOL, and (iii) identify predictors of HR-QOL. We collected demographic, clinical, and HR-QOL data from stage III/IV adult cancer patients at two major Vietnamese cancer centers. We determined the internal consistency (Cronbach’s alpha), construct validity (confirmatory factor analysis (CFA)), and discriminant validity (known-groups comparison) of the Vietnamese instrument. HR-QOL was analyzed descriptively. Multinomial logistic regressions identified predictors of HR-QOL. Results A total of 825 patients participated. Missing data were completely at random (MCAR) (chi-square = 14.270, df = 14, p = 0.430). Cronbach’s alpha for all items was 0.904. CFA loadings of physical, psychological, social relationship, and environment domains onto HR-QOL were 0.81, 0.82, 0.34, and 0.75, respectively. Prediction of scores differed significantly by functional status (Wilks’ lambda = 0.784, chi-square = 197.546, df = 4, p < 0.01, correct prediction = 74.6%). HR-QOL was reported as very bad/bad by n = 188 patients (22.8%) and general health as very bad/bad by n = 430 (52.1%). Multinomial logistic regression (likelihood ratio test: chi-square = 35.494, df = 24, p = 0.061, correct prediction = 62.2%) and the Pearson correlations revealed worse HR-QOL was associated with inpatient status, high ECOG score, and having dependent children. Conclusion The Vietnamese version of the WHOQOL-BREF has excellent internal consistency reliability and sound construct and discriminant validity in advanced cancer patients. Advanced cancer inpatients, those with dependent children, and those with poorer physical function appear to have the greatest palliative care needs.

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