Institute of the History of Medicine, Justus Liebig University Giessen Faculty of Medicine, Giessen, Germany.
Section of Translational Medical Ethics, National Center of Tumor Diseases, Heidelberg, Germany.
BMJ Open. 2023 Apr 4;13(4):e066998. doi: 10.1136/bmjopen-2022-066998.
To revise the 37-item Advanced Cancer Patients' Distress Scale (ACPDS) regarding its content, comprehensibility, applicability, and relevance by healthcare professionals (HCPs) and patients in order to enhance an existing instrument that is appropriate for the needs of patients with advanced cancer admitted to palliative care.
A preliminary revision of items regarding psychometric indices and relevance to initially shorten the scale, complemented by cognitive interviews with patients combining think-aloud and verbal-probe techniques and an HCP focus group on the detected remaining items. Interviews and the focus group were audio-recorded, transcribed verbatim and analysed using MAXQDA.
The study took place at a German palliative care unit.
10 patients were interviewed (50% female) and 6 HCPs (3 physicians, 2 nurses and 1 psychologist) participated in the focus group.
Comprehensibility, applicability, and relevance of the ACPDS were evaluated.
Based on the psychometric revision, a reduced number of 17 items was discussed by the HCP focus group and within cognitive interviews with patients. For the rest of the analysis of the HCP focus group and the patient interview data, the introduction of the ACPDS was simplified and adapted to everyday language. As recommended by HCPs and patients, the example question was replaced. Nine items were reworded to boost clarity, openness, redundancy and mitigation. Three items were eliminated, and another three items were added.
With this revised 17-item version of the ACPDS, we constructed an instrument that seems to be appropriate for the needs of patients with advanced cancer in a palliative care setting. In the next step, the shortened scale will be tested on psychometric data and validated by a large sample of inpatients on palliative care suffering from advanced cancer.
DRKS ID: DRKS00022425.
通过医疗保健专业人员 (HCP) 和患者对 37 项晚期癌症患者痛苦量表 (ACPDS) 进行内容、可理解性、适用性和相关性修订，以增强现有的适合晚期癌症患者的工具姑息治疗。
对与心理测量学指标和相关性相关的项目进行初步修订，最初缩短量表，同时结合使用出声思维和言语探针技术对患者进行认知访谈，并对剩余项目进行 HCP 焦点小组讨论。访谈和焦点小组进行了录音，并逐字转录，使用 MAXQDA 进行分析。
研究在德国姑息治疗病房进行。
10 名患者接受了访谈（50%为女性），6 名 HCP 参加了焦点小组（3 名医生、2 名护士和 1 名心理学家）。
评估 ACPDS 的可理解性、适用性和相关性。
基于心理测量学修订，HCP 焦点小组和认知访谈中讨论了减少的 17 项内容。对于 HCP 焦点小组和患者访谈数据的其余分析，简化了 ACPDS 的介绍并使其适应日常语言。根据 HCP 和患者的建议，更换了示例问题。对 9 个项目进行了改写，以提高清晰度、开放性、冗余度和缓解度。删除了 3 个项目，并添加了另外 3 个项目。
通过这个修订后的 17 项 ACPDS 版本，我们构建了一个似乎适合姑息治疗环境中晚期癌症患者需求的工具。在下一步中，将对该缩短量表进行心理测量学数据测试，并通过大量患有晚期癌症的姑息治疗住院患者进行验证。
DRKS ID：DRKS00022425。
