Background: Assessment of patients? palliative needs is important in the planning and evaluation of palliative care services. Palliative needs are often thought of as equivalent to symptoms and problems that exceed a certain acceptable level. However, it has been pointed out that even though the patients have problems/symptoms exceeding a certain level they do not necessarily have a need, and vice versa.
Aims: To develop a questionnaire supplementing the traditional measurement of symptom/problem intensity with measurement of other aspects of patients' needs.
Methods: A literature survey was conducted. The survey included existing questionnaires, and psychological and sociological theories regarding needs. On this basis we developed a model of needs assessment and used it to develop a questionnaire.
Results: We define an unmet need as a problem/symptom that is perceived as problematic, and for which the patient usually does not receive sufficient relief. The questionnaire consists of 24 items. Eleven items measure to what extent the patient experiences certain problems and symptoms as problematic. Eleven items measure if the patient receives help that relieves his/her particular problems or symptoms. Finally, we ask the patients if there are any symptoms or problems for which they would like more help, as well as to what degree the overall relief of symptoms and problems have been adequate. Pilot testing indicates that the questionnaire works well. It is planned to combine measurement of intensity (using the EORTC QLQ-C30) with measurement of the two other dimensions of need.
Conclusion: The measurement of patients? needs is a real challenge. The presented questionnaire has certain advantages and possibilities but clearly does not cover all aspects of needs assessment. The next step is a more thorough validation where the questionnaire results will be validated against results of interviews followed by use in a study of 400 patients.