A new self-rating scale has been developed to assess the care provided by nurses visiting the homes of patients receiving terminal cancer. Its development and evaluation was reported in a new study published in the American Journal of Hospice & Palliative Medicine®.
The development of an early draft version of the scale, Home Hospice Nursing Care Scale (HHNCS), began with a descriptive methodology survey provided to 118 tumor nurse specialists and certified tumor nurses related to certified tumor nurse stations and facilities. HHNCS includes items rated on a 4-point Likert scale, with scores corresponding to no implementation of items at all, and scores of 4 correspond to implementations appropriately.
A questionnaire survey was sent to potential research participants from the Enhanced Home Nursing Bureau of Kinki, Tokyo and Northern Regions of Japan for analysis of HHNCS. The questionnaire included a 76-item draft version of the HHNCS, in addition to previously developed scales (health professional attitudes towards terminal home care scales and the difficulties of health professionals with home palliative cancer care used to validate HHNCs and questions about participant demographics and expertise).
A total of 1770 surveys were submitted, with 559 (31.6%) responses received, of which 436 were considered valid and used for analysis. Corresponding participants included 428 women and 8 men, with most participants in their 40s or 50s in terms of age. Furthermore, most participants (93.3%) had experience in home hospice care learning beyond basic nursing education.
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This study developed and validated the reliability and validity of HHNCs and evaluated the care of cancer patients who spend their terminally ill days with their families at home.
In the end, one item was removed from the draft HHNCS, resulting in a scale of 75 items. Scale questions are grouped across five factors. Care that supports the values of patients and their families, partnerships that help patients and their families maintain home care, care that allows them to live with loved ones until the end of their lives, care that supports the daily lives of family caregivers, and care that regulates the emotions of those involved.
Confirmation factor analysis supported the ability of tools to fit real data. Cronbach's measurement-based reliability verification shows α-coefficients of 0.96 αα over the range of 0.77-0.93 for each factor, indicating that the reliability coefficient is higher than the reference value.
In the HHNC validation, this scale showed a moderate correlation with health professional attitudes towards terminally ill home care (R, 0.67; p <.01) and moderate negative correlation with health professional difficulty with health professional difficulty (r, −0.48; p <.01) with the Home Palliative Cancer Care Scale. Individual factors in HHNC reportedly showed significant correlations with these scales.
“This study developed and validated the reliability and validity of HHNCs and evaluated the care of cancer patients who spend their terminally ill days with their families at home,” the researchers wrote in their report.
