Comino María Rosa Salvador, Garcia Victor Regife, López Maria Auxiliadora Fernández, Feddersen Berend, Roselló María Luisa Martin, Sanftenberg Linda, Schelling Jörg
Geriatrics and Family Medicine, Emory University, Atlanta, United States.
Hospital Universitario Virgen del Rocio, Universitätsklinikum, Sevilla, Spain.
Gesundheitswesen. 2018 Oct;80(10):871-877. doi: 10.1055/s-0043-104215. Epub 2017 Jul 11.
Palliative medicine is an essential component of the health care system. Basic palliative care should be provided by primary care services (family physician and home nursing) with palliative-medical basic qualification. Often it is very difficult to identify patients that would profit from a specialized palliative care team. For the evaluation of the case complexity of a palliative patient, we present a Spanish diagnostic tool IDC-Pal, which tries to specify when, why and where a palliative patient should be referred. The aims of this study were the translation and cultural adaptation of the diagnostic tool for complexity in palliative care IDC-Pal to the German language, and the measurement of its feasibility and face validity.
During the first phase, a forward-backward translation with linguistic and cultural adaptation of the tool IDC-Pal as well as the validation of its content by a review committee was performed. During the second phase, the preliminary version of the tool was tested by 38 family physicians that were asked for a qualitative assessment using a 10-points Likert scale (1 = "strongly disagree" and 10 = "totally agree"). Finally, a definitive version was developed.
The translation and adaptation were achieved without major problems. Both feasibility and apparent validity of the tool IDC-Pal were rated as high. The mean response in the Likert scale was 7.79, with a SD of 0.36. Participants strongly agreed on the apparent validity of the tool with a mean of 7.82 and a SD of 0.26 and on its feasibility with a mean of 7.79, and a SD of 0.39.
A conceptually, culturally and linguistically equivalent version of the original instrument IDC-Pal was obtained. German family physicians agreed on the usability of IDC-Pal as a tool for rating the case complexity of palliative patients. These results indicate that physicians in Bavaria and eventually in Germany could benefit of the full validation of IDC-Pal.
姑息医学是医疗保健系统的重要组成部分。基本姑息治疗应由具备姑息医学基本资质的初级保健服务机构（家庭医生和家庭护理）提供。通常很难识别出能从专业姑息治疗团队中获益的患者。为评估姑息患者的病例复杂性，我们展示一种西班牙诊断工具IDC-Pal，它试图明确姑息患者应在何时、为何以及何处被转诊。本研究的目的是将姑息治疗复杂性诊断工具IDC-Pal翻译成德语并进行文化调适，同时测量其可行性和表面效度。
在第一阶段，对工具IDC-Pal进行了语言和文化调适的前后向翻译，并由一个评审委员会对其内容进行验证。在第二阶段，38名家庭医生对该工具的初步版本进行了测试，要求他们使用10分制李克特量表（1 = “强烈不同意”，10 = “完全同意”）进行定性评估。最后，开发出了最终版本。
翻译和调适过程没有出现重大问题。IDC-Pal工具的可行性和表面效度都被评为很高。李克特量表的平均回应为7.79，标准差为0.36。参与者对该工具的表面效度平均评分为7.82，标准差为0.26，对其可行性平均评分为7.79，标准差为0.39，他们强烈同意该工具的表面效度和可行性。
获得了原始工具IDC-Pal在概念、文化和语言上等效的版本。德国家庭医生认可IDC-Pal作为评估姑息患者病例复杂性工具的可用性。这些结果表明，巴伐利亚乃至德国的医生可能会从IDC-Pal的全面验证中受益。
