PNS11 PATIENT-CENTERED METHODS: CONSIDERATIONS FOR QUALITATIVE RESEARCH TO SUPPORT CONTENT VALIDITY WHEN DEVELOPING CLINICAL OUTCOME ASSESSMENT (COA) MEASURES APPROPRIATE FOR ADOLESCENT PATIENTS (AGED 12-17 YEARS OLD)

Introduction: To achieve stable control in warfarin therapy is challenging in clinical practice. Patients′ active participation is essential to promote self-care and medication adherence. We sought to build a conceptual map to substantiate the validation of EmpoderACO, in Brazilian Portuguese, a protocol for behavior change for patients on warfarin. Methods: This methodological study involved the development of a conceptual map focused on identifying self-care domains in warfarin users. Its content guided the development and validation of a behavior change protocol which comprised the following steps: definition of instrument objectives; construction and selection of items; construction and measurement of response scales; iv) structuring and assessment of content validity. The content validity was assessed by a committee of judges (CJ) and calculated by content validity coefficient (CVC). We used the software CmapTools (version 6.04, 2020) to build the conceptual map. Ethical approval 65928316.3.0000.5149. Results: Self-care domains in the conceptual map were divided into three categories: understanding and satisfaction with drug therapy; reduction of adverse events; promotion of well-being and healthy habits. The use of the conceptual map allowed the development of the final version of EmpoderACO with 27 items. A total of 34 specialists composed the multiprofessional CJ that analyzed the validity content. The overall average of CVC was ≥0.91, including relevance (0.92), adequacy (0.92) and clarity (0.91). Conclusions: The protocol EmpoderACO may contribute to a global approach of patients on warfarin to improve patient′s understanding of drug therapy, self-care behaviors and design of patient-centered care. The application of empowerment principles may be of particular utility in vulnerable populations living in low- and middle-income countries where warfarin is still widely prescribed for oral anticoagulation. Fig. 1 Conceptual map

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Clinical outcome assessment in mental health

Oxford Textbook of Public Mental Health ◽

10.1093/med/9780198792994.003.0022 ◽

2018 ◽

pp. 191-200

Author(s):

Skye P. Barbic ◽

Stefan J. Cano

Keyword(s):

Mental Health ◽

Decision Making ◽

Clinical Outcome ◽

Outcome Assessment ◽

Clinical Decision Making ◽

Clinical Decision ◽

Evidence Based ◽

Measurement Issues ◽

Health Disorders ◽

Based Medicine

Clinical outcome assessment (COA) in mental health is essential to inform patient-centred care and clinical decision-making. In this chapter, the reader is introduced to COA as it is evolving in the field of mental health. Multiple approaches to COA are presented, but emphasis is placed on approaches that generate clinically meaningful data. Understanding COA can position clinicians and stakeholders to better evaluate their own practice and to contribute to the ongoing evolution of COA research and evidence-based medicine. This chapter begins with the definitions of assessment and measurement. Conceptual frameworks and models of COA development and testing are then presented. These are followed by a discussion of measurement in practice that reviews measurement issues related to clinical decision-making, programme evaluation, and clinical trials. Finally, this chapter highlights the contribution of metrology to improving health outcomes of individuals who experience mental health disorders.

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Development and Psychometric Testing of Liver Transplant Therapeutic Adherence Questionnaire in a Triphasic Mixed-Method Study

Progress in Transplantation ◽

10.1177/1526924819835824 ◽

2019 ◽

Vol 29 (2) ◽

pp. 122-128

Author(s):

Fariba Tohidinezhad ◽

Mohsen Aliakbarian ◽

Ameen Abu-Hanna ◽

Saeid Eslami

Keyword(s):

Liver Transplant ◽

Mixed Method ◽

Content Validity ◽

Reliability And Validity ◽

Psychometric Testing ◽

Transplant Recipients ◽

Patient Centered ◽

Therapeutic Adherence ◽

Adherence Assessment ◽

Liver Transplant Recipients

Introduction: Due to the high nonadherence rate to posttransplant regimen and medical indications among liver transplant recipients, systematic patient-centered interventions are needed to improve the medium- and long-term graft and patient survival outcomes. Objective: The aim of this study was to develop and test the psychometric properties of Liver Transplant Therapeutic Adherence Questionnaire. Design: A mixed-method instrument design was conducted in 3 phases: (1) initial item collection was generated by inductive content analysis on internationally available resources, (2) item screening was carried out by a 3-member committee and 25 domain experts including nurses and physicians aiming to establish content validity, and (3) data were collected from 247 liver transplant recipients in May 2016 for psychometric testing. Results: A total of 221 knowledge statements were extracted as potential adherence assessment items. The qualitative screening phase resulted in top 35 important items. The second screening phase was performed quantitatively by 25 experts (n = 14 nurses, n = 7 gastroenterologists and hepatologists, and n = 4 transplant surgeons). A total of 16 items were associated with statistically significant content validity ratio values (≥0.37) to be included in the final questionnaire. Exploratory factor analysis revealed a distinct 4-factor structure that was labeled as: daily activities (α = .93), immunization (α = .93), nutrition (α = .92), and major complications (α = .79). Discussion: Our results reveal evidence of acceptable reliability and validity for Liver Transplant Therapeutic Adherence Questionnaire. This instrument makes it possible to measure recipients’ therapeutic adherence in both domains of research and practice.

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