Assessment of hospitalised cancer patients' needs by the Needs Evaluation Questionnaire.

BACKGROUND: Cancer disease modifies the order and the nature of needs connected with the state of health. The aim of this study was to evaluate the informative, psychological, social and practical needs of hospitalised cancer patients by means of the Needs Evaluation Questionnaire (NEQ), an instrument designed concisely for the convenience of patients and medical staff. PATIENTS AND METHODS: Different samples of consecutive hospitalised cancer patients were involved in the various phases of designing the instrument: 30 patients for items identification, 101 patients for completeness and acceptability evaluation, 423 patients for construct validity and prevalence of needs; content and reliability analysis were performed on 2 subsamples of, respectively, 60 and 88 of the patients from the last sample. RESULTS: The validation analysis showed rather good reliability, structure validity and internal consistency of the questionnaire. The prevalence analysis showed that the most common needs were: 'more information about my future conditions' (74%); 'more information about my diagnosis' (56%); 'more information about the exams I am undergoing' (52%); 'more explanations on treatments' (51%); 'to have a better dialogue with clinicians' (57%); 'better services from the hospital' (bathrooms, meals, cleaning) (56%). CONCLUSIONS: The NEQ, self-completed by patients, has proven to be a useful clinical tool for obtaining a systematic and undistorted overview of the principal needs with respect to the state of health of patients. This instrument, which can also be administered by persons not belonging to the health care system such as volunteers, and inserted into the patients' hospital charts, could be used by the medical staff to identify the real needs of patients at an early stage.

The code of conduct of the volunteer.

Voluntary service has experienced a considerable expansion and a substantial change over the last two decades. The role of the volunteer has gradually come to interact with activities undertaken by other professionals, but without interfering. Since the role of the volunteer naturally involves autonomy and discretion on his/her behalf, the associations concerned increasingly feel the need to refer to standards defining a voluntary service ethic. Within a refresher course with a set number of places for non-profit-making organisations, which was arranged by the Italian League against Cancer, Milan, a consensus conference for the ratification of a code of conduct on voluntary service was held. The aim was to reach a consensus together with others who work in an "organised" manner every day, on ethical concepts that should inspire voluntary service: the common good, mutual respect, freedom of choice, a non-profit-oriented vision. After exhaustive discussions by three panels, the text of a code of conduct unanimously approved was elaborated. All concerned with this code tried to avoid giving it a "sanitary" imprint. It is in fact our opinion that whatever the area covered by voluntary service, its aim and its final objective is to ensure the wellbeing of mankind and his environment.

Italian consensus on a curriculum for volunteer training in oncology.

Volunteers' education, together with selection and organization, are fundamental for an adequate volunteer service in oncology, which is focused on patient and family needs and is fully integrated with the activity of the care team. To achieve such an aim, well-defined requirements and educational objectives are essential. A curriculum for voluntary service in oncology was developed through a consensus of experts. By comparing the work carried out by six different teams, a questionnaire was drafted, which grouped 91 educational aims. For each, the questionnaire queried whether the aim was relevant or not, and, if yes, whether it should be pursued through (a) knowledge, (b) skill, and/or (c) attitude (with a possible multiple answer). To improve comprehension, the questionnaire was divided into five sections: (a) the association; (b) the disease, therapies, and care site; (c) voluntary service in oncology; (d) psychosocial aspects of the patient and family; and (e) approach, communication, and acceptance. The questionnaire was sent to 117 delegates from 93 Italian volunteer organizations who, during a period of 8 years, had attended a course for volunteer trainers held by the Italian League Against Cancer. As indicated in the letter forwarded with the questionnaire, the final document would report only the aims considered relevant by at least 70% of the participants. Moreover, the area(s) of pursuit (knowledge, skill, and attitude) would be stated for each goal when indicated by at least one-half of the participants. Of 117 individuals questioned, 83 (71%) replied. Of the 91 aims proposed, 60 were considered relevant, and a type of approach (knowledge, skill, and/or attitude) was suggested. The formative curriculum of voluntary service in oncology represents a consensual guideline for future training programs.

Volunteers in hospital and home care: a precious resource.

AIMS AND BACKGROUND: Ten years ago, a program of intervention by volunteers in cancer hospitals and at home was started. Home care is accomplished by teams of palliative care givers, in which volunteers are included. After a selective interview, all voluntary candidates with the necessary qualifications are trained and specific apprenticeship is done. Hence, their professional training is carried out through regular groups of supervision followed by a psychologist and a coordinator. A study was carried out to evaluate the activity of volunteers, in the hospital and at home, as judged by patients, nurses and the volunteers themselves. METHODS: On the whole, the data analyzed concerned 216 patients, 163 nurses and 92 volunteers in the hospital and 30 patients, 16 nurses and 35 volunteers at home. The questionnaires used for the study had four possible answers (no, a little, much, very much) or required an answer on a scale of 0 to 10. RESULTS: A high quota of patients gave a very positive opinion ("much" or "very much") on the importance of the presence of volunteers in the hospital (76%) and at home (90%). In the second case, volunteers were particularly useful to improve a patient's mood (80%) and to solve practical problems (47%). General agreement was noted among nurses and volunteers on the activity of the latter. The main form of intervention of all volunteers is to give psychosocial support to patients. A score of 7 to 10 was given to this item by 60% of the nurses and by 82% of the hospital volunteers. At home, respectively 80% and 89% gave such a score for the same item. Other activities of the volunteer were support for the family, assistance in social activities, and to give information. CONCLUSIONS: The presence of the volunteer in the hospital and at home appears to be helpful to the patient and the family by becoming part of the team without becoming involved directly in its clinical activity.