基于COSMIN指南对癌症患者支持性照护需求量表的系统评价

背景国内外用于评估癌症患者支持性照护需求的量表较多，但有关此类量表质量的标准化评价研究及不同量表间的横向比较研究较为缺乏，也少有研究者对此类量表的测量特性进行系统的整合与评价。目的评价中文版癌症患者支持性照护需求量表的测量学性能及研究的方法学质量。方法2021年4月检索中国知网、万方数据知识服务平台、维普中文科技期刊全文数据库、中国生物医学文献数据库、PubMed、EmBase、Web of Science、CINAHL Complete数据库，获取有关中文版癌症患者支持性照护需求量表测量学性能评价的研究，检索时限均为建库至2021年3月30日。由两位研究者独立筛选文献、提取资料后，采用健康测量工具遴选标准（COSMIN）系统综述指南，在对量表的测量特性及研究的方法学质量进行评价的基础上，综合评定中文版癌症患者支持性照护需求评估量表各测量特性的证据等级，并形成对于量表的最终推荐意见。采用描述分析法对评价结果进行汇总、分析。结果共纳入15项研究，涉及8个中文版癌症患者支持性照护需求评估量表〔癌症患者支持性照护需求简明问卷中文版（SCNS-SF34）、中文版支持性照护需求筛查工具（SCNS-ST9-C）、癌症患者综合需求评估量表（CNAT）、癌症需求简明问卷（CNQ-SF）、中文版癌症患者未满足需求量表（CaSUN-C）、癌症患者未满足需求简明量表（SF-SUNS）、晚期癌症患者需求评估问卷（ACNQ-41）、晚期癌症患者需求评估表简表（ACNQ-29）〕。就量表的测量特性质量而言，除ACNQ-29的内容效度为"未提及"外，其余7个量表的内容效度均为"不确定"；除CaSUN-C、SF-SUNS的结构效度为"充分"外，其余6个量表的结构效度均为"不确定"；SCNS-SF34、CNQ-SF、CaSUN-C、SF-SUNS的内部一致性为"充分"，ACNQ-41的内部一致性为"不充分"，其余3个量表的内部一致性为"不确定"；CNAT、CNQ-SF、ACNQ-29的假设检验为"未提及"，CaSUN-C、SF-SUNS、ACNQ-41的假设检验为"不确定"，SCNS-SF34、SCNS-ST9-C的假设检验为"充分"；除ACNQ-41的稳定性为"不充分"，SCNS-ST9-C、ACNQ-29的稳定性为"未提及"外，其余5个量表的稳定性均为"充分"；仅SCNS-SF34的跨文化效度为"充分"，其余7个量表的跨文化效度均为"未提及"。8个量表的推荐等级均为B级。结论SCNS-SF34的测量特性得到了最为全面的评价，其具有较好的信效度，且临床应用可行性高，可暂时被推荐使用，但上述结论仍有待更多高质量证据加以支撑。

A Systematic Review of Universal Supportive Care Needs Scale for Cancer Patients Based on COSMIN Guidelines

Background There are many scales used to assess the universal supportive care needs for cancer patients at home and abroad,but there is a lack of standardized evaluation research on the quality of such scales and horizontal comparison research between different scales.Few researchers have systematically integrated and evaluated the measurement characteristics of such scales.Objective To evaluate the quality of psychometric properties and methodological quality of the Chinese version of the universal supportive care needs scale for cancer patients.Methods In April 2021,CNKI,Wanfang Data knowledge service platform,Whipple Journal full-text database,Chinese Biomedical Literature database,PubMed,EmBase,Web of Science and CINAHL Complete Database were retrieved to collect the Chinese version of the universal supportive care needs scale for cancer patients from the time of database establishment to March 30,2021.After 2 researchers independently screened the literature and extracted the data,the guidelines were systematically reviewed using the selection criteria for health measurement tools.Based on the evaluation of the measurement characteristics of the scale and the methodological quality of the research,the level of evidence for the measurement characteristics of the Chinese version of the supportive care needs assessment scale for cancer patients were comprehensively evaluated.All available studies were qualitatively summarised to formulate recommendations.Results A total of 15 studies were included,involving 8 Chinese version of the supportive care needs assessment scale for cancer patients〔the 34-item Short Form Supportive Care Needs Survey(SCNS-SF34),Supportive Care Needs Survey Screening Tool Chinese version(SCNS-ST9-C),Comprehensive Needs Assessment Tool in Cancer for Patients(CNAT),Career Needs Questionnaires-Short Form(CNQ-SF),Chinese Cancer Survivor's Unmet Needs(CaSUN-C),the Short-Form Survivor Unmet Needs Survey(SF-SUNS),Advanced Cancer Patient Needs Questionnaire(ACNQ-41),short version of Advanced Cancer Patient Needs Questionnaire(ACNQ-29)〕.In terms of content validity,except that the overall rating of ACNQ-29 was evaluated as"not mentioned",the overall rating of the other seven scales was evaluated as"uncertain";In terms of structural validity,except that the overall rating of CaSUN-C、SF-SUNS was rated as"sufficient",the overall rating of the other six scales was rated as"uncertain";In terms of internal consistency,the overall rating of SCNS-SF34、CNQ-SF、CaSUN-C、SF-SUNS was assessed as"sufficient",the overall rating of ACNQ-41 was assessed as"insufficient",and the overall rating of the other three scales was assessed as"uncertain";In terms of cross-cultural validity,only the overall rating of SCNS-SF34 was rated as"sufficient",and the overall rating of the other seven scales was rated as"not mentioned";In terms of stability,except that the overall rating of ACNQ-41 was evaluated as"insufficient"and the overall rating of SCNS-ST9-C、ACNQ-29 was rated as"not mentioned",the overall rating of the other five scales was evaluated as"sufficient";In terms of hypothesis testing,the overall rating of three scales was assessed as"not mentioned"(CNAT、CNQ-SF、ACNQ-29)and"uncertain"(CaSUN-C、SF-SUNS、ACNQ-41),respectively,and the overall rating of SCNS-SF34、SCNS-ST9-C was assessed as"sufficient".The recommended rating of eight scales was grade B.Conclusion SCNS-SF34 is the scale with the most comprehensive measurement characteristics with good reliability and validity and high clinical application feasibility,which can be temporarily recommended for use,but it needs further testing.