The "Qualy" Observatory, WHO Collaborating Centre for Public Health Palliative Care Programs, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain.
Palliative Care, University of Vic-Central University of Catalonia, Vic, Spain.
Palliat Support Care. 2019 Aug;17(4):441-447. doi: 10.1017/S1478951518000652.
The goal of this study is to describe the development of a new tool, the Psychosocial and Spiritual Needs Evaluation scale Instrumento de Evaluación de Necesidades Psicosociales y Espirituales del Enfermo al Final de Vida (ENP-E), designed to assess the psychosocial needs of end-of-life (EOL) patients. And, secondarily, to describe the face validity and psychometric properties of this instrument in the Spanish-speaking context.
The scale was developed through a seven-stage process: (1) literature review; (2) expert panel establishment; (3) discussion and agreement on the most relevant dimensions of psychosocial care; (4) description of key indicators and consensus-based questions to evaluate such dimensions; (5) assessment of the scale by external palliative care (PC) professionals; (6) evaluation by patients; and (7) analysis of scale's psychometrics properties. To assess content validity, 30 PC professionals and 20 patients evaluated the questionnaire. To determine psychometric properties, 150 participants completed these scales: the ENP-E; the Hospital Anxiety and Depression Scale; item 15 from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative; and the Distress Thermometer.
All respondents evaluated the tool as "excellent." In terms of construct validity, the internal consistency (Cronbach's alpha = 0.74) and temporal stability (test-retest r = 0.74, p < 0.1) were both adequate. On the factorial analysis, four factors (emotional-wellbeing, social support, spiritual, and information) explained 58.4% of the variance. This scale has a sensitivity of 76.3%, specificity of 78.9%, and the cutoff is 28.
To provide quality PC to EOL patients, it is essential to determine the psychosocial factors that influence well-being. This requires the use of reliable and specific instruments. The ENP-E is a novel tool that provides a systematic, holistic assessment of the psychosocial needs of EOL patients. Its routine use would allow clinicians to monitor such needs over time. This would, in turn, permit comprehensive, highly individualized interventions to improve effective PC approach.
本研究旨在描述一种新工具的开发,即生命终末期患者的心理社会和精神需求评估量表(Instrumento de Evaluación de Necesidades Psicosociales y Espirituales del Enfermo al Final de Vida,ENP-E),用于评估生命终末期患者的心理社会需求。其次,描述该工具在西班牙语环境下的表面效度和心理测量学特性。
该量表通过七个阶段的过程进行开发:(1)文献回顾;(2)建立专家小组;(3)讨论并达成心理社会关怀的最相关维度的共识;(4)描述关键指标和基于共识的问题以评估这些维度;(5)外部姑息治疗(PC)专业人员对量表进行评估;(6)患者评估;(7)量表心理测量学特性的分析。为了评估内容效度,30 名 PC 专业人员和 20 名患者对问卷进行了评估。为了确定心理测量学特性,150 名参与者完成了以下量表:ENP-E;医院焦虑和抑郁量表;欧洲癌症研究与治疗组织生活质量问卷核心 15 项姑息治疗量表第 15 项;以及痛苦温度计。
所有受访者均将该工具评为“优秀”。在结构效度方面,内部一致性(Cronbach's alpha = 0.74)和时间稳定性(测试-重测 r = 0.74,p < 0.1)均足够。在因子分析中,四个因素(情绪健康、社会支持、精神和信息)解释了 58.4%的方差。该量表的灵敏度为 76.3%,特异性为 78.9%,截断值为 28。
为了为生命终末期患者提供优质的 PC,确定影响幸福感的心理社会因素至关重要。这需要使用可靠和特定的工具。ENP-E 是一种新颖的工具,可对生命终末期患者的心理社会需求进行系统、全面的评估。常规使用该工具可以使临床医生随时间监测这些需求。这反过来又可以促进综合的、高度个体化的干预措施,以改善有效的 PC 方法。