Ronald O. Perelman Department of Emergency Medicine, 12296New York University Grossman School of Medicine, New York, NY, USA.
Emergency Department55174, CHU Clermont-Ferrand, Clermont-Ferrand, France.
Am J Hosp Palliat Care. 2023 Mar;40(3):280-290. doi: 10.1177/10499091221098664. Epub 2022 May 12.
Emergency providers can engage in goals of care discussions and hospice and palliative care referrals. Little is known about their knowledge and attitudes, which may influence these care practices. This study aims to re-validate the knowledge and attitude towards hospice and palliative care (KAHP) scale and assess the scale's latent constructs among emergency providers. The scale consists of ten items measured on a five-point Likert scale. Five of the ten items were reverse scored. Content validation was performed by ten experts in Hospice and Palliative Medicine and Emergency Medicine. Baseline surveys of emergency physicians, advance practice providers, and nurses conducted in the context of a pragmatic, randomized control trial were used for the item analysis and the exploratory and confirmatory factor analyses. The KAHP scale is a ten-item scale scored from 10 to 50. Based on the synthesis of content validation results and the item analysis, all ten items were retained. The item and scale Content Validity Index were each .91. The reliability of the scale was .64 and the exploratory factor analysis identified three underlying constructs defined as self-rated knowledge, support for hospice and palliative care practice, and views on provider-patient communication. The presence of good model fit indices supported the structural integrity of the constructs. We present a validated instrument that is suitable for assessing knowledge and attitude variations toward interventions designed to improve hospice and palliative care practice among emergency providers.
急救提供者可以参与医疗照护目标讨论和临终关怀及缓和医疗转介。然而，对于急救提供者的相关知识和态度知之甚少，而这些因素可能会影响这些医疗照护实践。本研究旨在重新验证急救提供者对临终关怀和缓和医疗（KAHP）的知识和态度量表（KAHP），并评估该量表在急救提供者中的潜在结构。该量表由十个项目组成，采用五点 Likert 量表进行测量。其中五个项目进行了反向评分。内容验证由十名临终关怀和姑息医学以及急诊医学专家进行。在一项实用的随机对照试验中，对急诊医师、高级实践提供者和护士进行了基线调查，用于进行项目分析以及探索性和验证性因素分析。KAHP 量表是一个 10 项量表，评分范围为 10 至 50。基于内容验证结果和项目分析的综合，保留了所有十个项目。项目和量表内容效度指数均为.91。该量表的信度为.64，探索性因素分析确定了三个潜在结构，分别为自我评估的知识、对临终关怀和姑息医疗实践的支持，以及对医患沟通的看法。良好的模型拟合指数支持了结构的完整性。我们提出了一种经过验证的工具，适用于评估急救提供者对旨在改善临终关怀和姑息医疗实践的干预措施的知识和态度变化。
