Van Scoy L J, Scott A M, Reading J M, Chuang C H, Chinchilli V M, Levi B H, Green M J
Department of Medicine and Humanities, Penn State Milton S. Hershey Medical Center, United States.
Department of Communication, University of Kentucky, United States.
Patient Educ Couns. 2017 May;100(5):909-918. doi: 10.1016/j.pec.2016.12.010. Epub 2016 Dec 15.
To describe how multiple goals theory can be used as a reliable and valid measure (i.e., coding scheme) of the quality of conversations about end-of-life issues.
We analyzed conversations from 17 conversations in which 68 participants (mean age=51years) played a game that prompted discussion in response to open-ended questions about end-of-life issues. Conversations (mean duration=91min) were audio-recorded and transcribed. Communication quality was assessed by three coders who assigned numeric scores rating how well individuals accomplished task, relational, and identity goals in the conversation.
The coding measure, which results in a quantifiable outcome, yielded strong reliability (intra-class correlation range=0.73-0.89 and Cronbach's alpha range=0.69-0.89 for each of the coded domains) and validity (using multilevel nonlinear modeling, we detected significant variability in scores between games for each of the coded domains, all p-values <0.02).
Our coding scheme provides a theory-based measure of end-of-life conversation quality that is superior to other methods of measuring communication quality.
Our description of the coding method enables researches to adapt and apply this measure to communication interventions in other clinical contexts.
描述多重目标理论如何用作衡量临终问题对话质量的可靠且有效的方法（即编码方案）。
我们分析了17次对话，其中68名参与者（平均年龄=51岁）玩了一个游戏，该游戏针对有关临终问题的开放式问题引发讨论。对话（平均时长=91分钟）进行了录音和转录。由三名编码员评估沟通质量，他们给出数字评分，以评定个体在对话中完成任务、建立关系和实现身份目标的情况。
该编码方法产生了可量化的结果，具有很高的信度（组内相关系数范围=0.73 - 0.89，每个编码领域的Cronbach's α系数范围=0.69 - 0.89）和效度（使用多层非线性模型，我们检测到每个编码领域在不同游戏间的分数存在显著差异，所有p值<0.02）。
我们的编码方案提供了一种基于理论的临终对话质量衡量方法，优于其他衡量沟通质量的方法。
我们对编码方法的描述使研究人员能够在其他临床环境中对沟通干预措施采用并应用此方法。
