Determinants of Nephrology Provider Engagement in Comprehensive Pre-Dialysis Discussions with Older Adults: Scale Development and Psychometric Evaluation.

Comprehensive pre-dialysis discussions between providers and older adults over age 75 years are needed but often lacking. The aim of this study was to develop an instrument to assess behavioral determinants of nephrology provider use of comprehensive pre-dialysis discussions with older adults. Study design consisted of cross-sectional development of the instrument and preliminary psychometric evaluation. Items were based on an integrated literature review, expert clinician input, and the Theory of Planned Behavior. Nephrologists, nurse practitioners, and physician assistants completed the instrument (n = 71). Baseline demographic data, exploratory factor analysis, and Cronbach's alpha were analyzed. Initial factor analysis using principal components analysis and subsequent orthogonal rotation revealed loading on a four-factor model. Cronbach's alphas for the instrument/items were 0.89/0.83 to 0.94. Variance explained by the four factors was 58%.