title: Comprehensive needs assessment tool in cancer (CNAT): the development and validation.
abstract: OBJECTIVE
  Needs assessment is an important step toward quality and patient-centered cancer care, as it identifies patient need, guiding evidence-based cancer care policy, and maximizing care outcome. This study reports on the development and validation of comprehensive needs assessment tool in cancer (CNAT).
  
  
  METHODS
  The CNAT, 59-item needs assessment tool for cancer was developed and validated in a large scale multi-center survey involving 2,661 cancer patients in ten fairly distributed cancer centers throughout Korea.
  
  
  RESULTS
  To ensure content validity of the CNAT, items were derived from major needs assessment tools and input from experts and patients. Exploratory factor analysis confirmed its construct validity and identified seven factors: health care staff, psychological problems, physical symptoms, information, social and religious/spiritual support, practical support, and hospital facilities/services. Cronbach's alpha for the scale was 0.97, and for subscales, it varied from 0.80 to 0.97. Convergent validity was demonstrated by its significant association with the EQ5D. Patients with elevated stress, depressive episodes, or suicidal ideation reported a significantly higher level of psychological and overall need. Known-group validity was also supported by its ability to detect significant differences according to age, gender, education, insurance status, months since diagnosis, and non-surgical anticancer treatment. Needs differed according to SEER stage and cancer type: advanced stage and breast and lung cancer were associated with a greater level of need.
  
  
  CONCLUSIONS
  The CNAT constitutes a meaningful and valid response to the challenges of cancer care, enabling assessment of need in cancer with a comprehensive yet concise and psychometrically sound tool.
authors.affiliation: Department of Psychology, Catholic University of Daegu, 330 Geumrak 1-Ri, Hayang-eup, Gyeongsan-si, GyeongBuk 712-702, Republic of Korea.
authors.forename: Eun-Jung
authors.initials: EJ
authors.lastname: Shim
authors.forename: Kyung-Sook
authors.initials: KS
authors.lastname: Lee
authors.forename: Jong-Hyock
authors.initials: JH
authors.lastname: Park
authors.forename: Jae-Hyun
authors.initials: JH
authors.lastname: Park
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009369:Neoplasms; D056910:Republic of Korea; D011795:Surveys and Questionnaires / Q000592:standards*