Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada.
Department of Oncology, Cumming School of Medicine, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada.
Patient. 2020 Jun;13(3):327-337. doi: 10.1007/s40271-020-00409-8.
Although compassionate care is considered a cornerstone of quality palliative care, there is a paucity of valid and reliable measures to study, assess, and evaluate how patients experience compassion/compassionate care in their care.
The aim was to develop a patient-reported compassion measure for use in research and clinical practice with established content-related validity evidence for the items, question stems, and response scale.
Content validation for an initial 109 items was conducted through a two-round modified Delphi technique, followed by cognitive interviews with patients. A panel of international Subject Matter Experts (SMEs) and a Patient Advisory Group (PAG) assessed the items for their relevancy to their associated domain of compassion, yielding an Item-level Content Validity Index (I-CVI), which was used to determine content modifications. The SMEs and the PAG also provided narrative feedback on the clarity, flow, and wording of the instructions, questions, and response scale, with items being modified accordingly. Cognitive interviews were conducted with 16 patients to further assess the clarity, comprehensibility, and readability of each item within the revised item pool.
The first round of the Delphi review produced an overall CVI of 72% among SMEs and 80% among the PAG for the 109 items. Delphi panelists then reviewed a revised measure containing 84 items, generating an overall CVI of 84% for SMEs and 86% for the PAG. Sixty-eight items underwent further testing via cognitive interviews with patients, resulting in an additional 14 items being removed.
Having established this initial validity evidence, further testing to assess internal consistency, test-retest reliability, factor structure, and relationships to other variables is required to produce the first valid, reliable, and clinically informed patient-reported measure of compassion.
尽管同情关怀被认为是优质姑息治疗的基石，但目前缺乏有效的、可靠的方法来研究、评估和评估患者在护理过程中对同情/同情关怀的体验。
旨在开发一种患者报告的同情度量标准，用于研究和临床实践，并为项目、问题根源和响应量表提供既定的内容相关有效性证据。
通过两轮改良德尔菲技术对最初的 109 项内容进行了验证，随后对患者进行了认知访谈。一个国际主题专家 (SMEs) 和一个患者咨询小组 (PAG) 小组对与同情相关的项目进行了评估，以确定其与相关领域的相关性，从而得出项目级内容有效性指数 (I-CVI)，用于确定内容修改。SMEs 和 PAG 还就说明、问题和响应量表的清晰度、流畅性和措辞提供了叙述性反馈，相应地修改了项目。还对 16 名患者进行了认知访谈，以进一步评估修订后的项目池中每个项目的清晰度、理解性和可读性。
德尔菲审查第一轮对 SME 产生了 72%的总体 CVI，对 PAG 产生了 80%的总体 CVI，对 109 项进行了审查。德尔菲小组成员随后审查了包含 84 项的修订后的度量标准，为 SME 生成了 84%的总体 CVI，为 PAG 生成了 86%的总体 CVI。对患者进行了 68 项认知访谈测试，导致另外 14 项被删除。
在建立了这一初步有效性证据之后，还需要进行进一步的测试，以评估内部一致性、测试-重测可靠性、因素结构以及与其他变量的关系，从而产生第一个有效、可靠和具有临床意义的患者报告的同情度量标准。
