Dept Palliative Care, King's College London, Weston Education Centre, Denmark Hill, London SE5 9RJ, UK.
Health Qual Life Outcomes. 2010 Jan 25;8:10. doi: 10.1186/1477-7525-8-10.
Despite the burden of progressive incurable disease in Africa, there is almost no evidence on patient care or outcomes. A primary reason has been the lack of appropriate locally-validated outcome tools. This study aimed to validate a multidimensional scale (the APCA African Palliative Outcome Scale) in a multi-centred international study.
Validation was conducted across 5 African services and in 3 phases: Phase 1. Face validity: content analysis of qualitative interviews and cognitive interviewing of POS; Phase 2. Construct validity: correlation of POS with Missoula-Vitas Quality of Life Index (Spearman's rank tests); Phase 3. Internal consistency (Cronbach's alpha calculated twice using 2 datasets), test-retest reliability (intraclass correlation coefficients calculated for 2 time points) and time to complete (calculated twice using 2 datasets).
The validation involved 682 patients and 437 family carers, interviewed in 8 different languages. Phase 1. Qualitative interviews (N = 90 patients; N = 38 carers) showed POS items mapped well onto identified needs; cognitive interviews (N = 73 patients; N = 29 carers) demonstrated good interpretation; Phase 2. POS-MVQoLI Spearman's rank correlations were low-moderate as expected (N = 285); Phase 3. (N = 307, 2nd assessment mean 21.2 hours after first, SD 7.2) Cronbach's Alpha was 0.6 on both datasets, indicating expected moderate internal consistency; test-retest found high intra-class correlation coefficients for all items (0.78-0.89); median time to complete 7 mins, reducing to 5 mins at second visit.
The APCA African POS has sound psychometric properties, is well comprehended and brief to use. Application of this tool offers the opportunity to at last address the omissions of palliative care research in Africa.
尽管非洲患有进行性不治之症的患者负担沉重，但几乎没有关于患者护理或结局的证据。一个主要原因是缺乏适当的、经当地验证的结局工具。本研究旨在进行一项多中心国际研究，以验证多维量表（APCA 非洲姑息治疗结局量表）。
在 5 个非洲服务中心分 3 个阶段进行验证：第 1 阶段：表面效度：对定性访谈和 POS 的认知访谈进行内容分析；第 2 阶段：构念效度：POS 与密苏拉-维塔斯生活质量指数（Spearman 秩检验）的相关性；第 3 阶段：内部一致性（使用 2 个数据集两次计算 Cronbach's alpha）、测试-重测可靠性（为 2 个时间点计算组内相关系数）和完成时间（使用 2 个数据集两次计算）。
验证工作涉及 682 名患者和 437 名家属，以 8 种不同语言进行访谈。第 1 阶段：定性访谈（N = 90 名患者；N = 38 名家属）表明 POS 项目与确定的需求密切相关；认知访谈（N = 73 名患者；N = 29 名家属）表明解释良好；第 2 阶段：POS-MVQoLI Spearman 秩相关预期为低中度（N = 285）；第 3 阶段：（N = 307，第二次评估平均在第一次评估后 21.2 小时，标准差 7.2）两个数据集的 Cronbach's Alpha 均为 0.6，表明预期的中度内部一致性；测试-重测发现所有项目的组内相关系数均较高（0.78-0.89）；中位数完成时间为 7 分钟，第二次就诊时减少到 5 分钟。
APCA 非洲 POS 具有良好的心理测量学特性，易于理解和使用。该工具的应用为解决非洲姑息治疗研究中的遗漏问题提供了机会。
