Validity,Reliability, and Diagnostic Accuracy of the Respiratory Distress Observation Scale for Assessment of Dyspnea in Adult Palliative Care Patients

Background

The prevalence and severity of dyspnea increase at the end of life. Many of these patients have difficulty in reporting their symptoms. Accurate surrogate measures are needed for appropriate assessment and treatment. The Respiratory Distress Observation Scale (RDOS) is proposed as a possible scale although more external validation is needed. We set out to validate the RDOS in the context of palliative care patients near the end of life.

Development and Validation of the Palliative Care Attitudes Scale (PCAS-9): A Measure of Patient Attitudes Toward Palliative Care

ContextPalliative Care is underutilized, and research has neglected patient-level factors including attitudes that could contribute to avoidance or acceptance of Palliative Care referrals. This may be due in part to a lack of existing measures for this purpose.ObjectivesThe objective of this study was to develop and validate a nine-item scale measuring patient attitudes toward Palliative Care, comprised of three subscales spanning emotional, cognitive, and behavioral factors.MethodsData were collected online in three separate waves, targeting individuals with cancer (Sample 1: N = 633; Sample 2: N = 462) or noncancer serious illnesses (Sample 3: N = 225). Participants were recruited using ResearchMatch.org and postings on the web sites, social media pages, and listservs of international health organizations.ResultsInternal consistency was acceptable for the total scale (α = 0.84) and subscales: emotional (α = 0.84), cognitive (αs = 0.70), and behavioral (α = 0.90). The PCAS-9 was significantly associated with a separate measure of Palliative Care attitudes (ps < 0.001) and a measure of Palliative Care knowledge (ps < 0.004), supporting its construct validity in samples of cancer and noncancer serious illnesses. The scale's psychometric properties, including internal consistency and factor structure, generalized across patient subgroups based on diagnosis, other health characteristics, and demographics.ConclusionFindings support the overall reliability, validity, and generalizability of the PCAS-9 in serious illness samples and have implications for increasing Palliative Care utilization via clinical care and future research efforts.     

ICU患者安全文化测评量表的研制及信效度检验

目的 研制ICU患者安全文化测评量表,并对所研制的量表进行信效度检验.方法 通过文献分析、质性访谈、2轮德尔菲(Delphi)专家咨询,形成“ICU患者安全文化测评量表”的原始量表.然后对235名医护人员进行预调查,评价其信效度.结果 初步形成45个条目,经初步主观筛选、项目分析、探索性因子分析后删除11个条目.应用主成分分析法,提取了特征值＞1的7个公因子,其累积贡献率为59.347％.该量表总的Cronbach α系数为0.909,折半信度为0.832.各维度的Cronbach α系数在0.481～0.909,折半信度为0.481～0.866.以上均具有统计学意义.结论 编制的《ICU患者安全文化测评量表》具有较好的信效度,可用于评价ICU患者安全文化氛围.