Supportive Care in Cancer

, Volume 19, Issue 12, pp 1957–1968 | Cite as

Comprehensive needs assessment tool in cancer (CNAT): the development and validation

  • Eun-Jung Shim
  • kyung-Sook Lee
  • Jong-Hyock Park
  • Jae-Hyun ParkEmail author
Original Article



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).


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.


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.


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.


Neoplasms Cancer Needs assessment Validation 



This study has been supported by the promotion program for the new faculty, Sungkyunkwan University (2009) and a grant from the National Cancer Center (Grant number; 0710170, 0910191), Republic of Korea. The authors would also like to thank the reviewers of this paper for their valid suggestions, which contributed to the improvement of the paper.

Financial disclosure/conflicts of interest


Supplementary material

520_2010_1037_MOESM1_ESM.doc (124 kb)
ESM 1 (DOC 123 kb)


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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Eun-Jung Shim
    • 1
  • kyung-Sook Lee
    • 2
  • Jong-Hyock Park
    • 2
  • Jae-Hyun Park
    • 3
    Email author
  1. 1.Department of PsychologyCatholic University of DaeguGyeongsan-siRepublic of Korea
  2. 2.Division of Cancer Policy and Management, National Cancer Control Research InstituteNational Cancer CenterGoyang-siRepublic of Korea
  3. 3.Department of Social and Preventive Medicine, Samsung Biomedical Research InstituteSungkyunkwan University College of MedicineSuwonRepublic of Korea

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