20 Validation of the support needs approach for patients (SNAP) tool to enable patients with advanced copd to identify and express their support needs to healthcare professionals

2018 ◽  
Vol 8 (3) ◽  
pp. 367.2-367
Author(s):  
Carole Gardener ◽  
Gail Ewing ◽  
Morag Farquhar
Keyword(s):  
Palliative Care ◽  
Content Validity ◽  
Healthcare Professionals ◽  
Depression Scale ◽  
Criterion Validity ◽  
Postal Survey ◽  
Support Needs ◽  
Framework Approach ◽  
The Face ◽  
The Impact

IntroductionPatient identified need is key to delivering a person-centred approach in supportive and palliative care. The support needs approach for patients (SNAP) tool aims to enable patients with advanced COPD to identify and express their support needs to healthcare professionals (HCPs) but its validity is unknown.AimTo establish the face content and criterion validity of the SNAP tool in advanced COPD.MethodsTwo-stage mixed method primary care study involving patients with advanced COPD and their carers. Stage 1: Face and content validity assessed though focus groups involving patients and carers (n=12) considering appropriateness relevance and completeness of the SNAP tool. Thematic data analysis within a Framework Approach. Stage 2: Content and criterion validity assessed in a postal survey through patient self-completion of the SNAP tool and disease impact measures (chronic respiratory questionnaire COPD assessment test and hospital anxiety and depression scale). Content validity assessed using summary statistics; criterion validity via correlations between tool items and impact measures.ResultsThe SNAP tool has good face content and criterion validity. Patients and carers found the tool patient-friendly with potential clinical utility. No tool items were redundant. Clear correlations were found between tool items and the majority of items/sub-scales of the impact measures.DiscussionThe SNAP tool has good face content and criterion validity. It has the potential to support the delivery of supportive and palliative care in advanced COPD by enabling patients to identify and express their support needs to HCPs. Future work will pilot SNAP in clinical practice.

scholarly journals Support Needs Approach for Patients (SNAP) tool: a validation study

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e032028
Author(s):  
A Carole Gardener ◽  
Gail Ewing ◽  
Silvia Mendonca ◽  
Morag Farquhar
Keyword(s):  
Content Validity ◽  
Depression Scale ◽  
Criterion Validity ◽  
Postal Survey ◽  
Research Network ◽  
Chronic Obstructive ◽  
Support Needs ◽  
Informal Carer ◽  
Stage 1 ◽  
The Impact

ObjectivesPatient-identified need is key to delivering holistic, supportive, person-centred care, but we lack tools enabling patients to express what they need to manage life with a long-term condition. The Support Needs Approach for Patients (SNAP) tool was developed to enable patients with advanced chronic obstructive pulmonary disease (COPD) identify and express their unmet support needs to healthcare professionals (HCPs), but its validity is unknown. This study aimed to establish face, content and criterion validity of the SNAP tool.DesignTwo-stage mixed-methods study involving patients with advanced COPD and their carers. Stage 1: Face and content validity assessed though focus groups involving patients and carers considering appropriateness, relevance and completeness of the SNAP tool. Data were analysed using conventional content analysis. Stage 2: Content and criterion validity assessed in a postal survey through patient self-completion of the SNAP tool and disease impact measures (Chronic Respiratory Questionnaire, COPD Assessment Test, and Hospital Anxiety and Depression Scale). Content validity assessed using summary statistics; criterion validity via correlations between tool items and impact measures.Settings and participantsTwo hundred and forty patients and carers participated. Stage 1 patient and informal carer participants were recruited from two primary care practices and Stage 2 patients from 28 practices. Participating practices located in the East of England were recruited via the NIHR Clinical Research Network: Eastern.ResultsPatients and carers found the tool patient-friendly and comprehensive, with potential clinical utility. No tool items were redundant. Clear correlations were found between tool items and the majority of items in the impact measures.ConclusionsThe SNAP tool has good face, content and criterion validity. It has potential to support the delivery of holistic, supportive, person-centred care by enabling patients to identify and express their unmet support needs to HCPs.

Validating the Support Needs Approach for Patients (SNAP) tool in primary care: a person-centred approach for patients with advanced chronic obstructive pulmonary disease (COPD)

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X697301
Author(s):  
Carole Gardner ◽  
Gail Ewing ◽  
Morag Farquhar
Keyword(s):  
Primary Care ◽  
Health Care Professionals ◽  
Content Validity ◽  
Depression Scale ◽  
Criterion Validity ◽  
Postal Survey ◽  
Face Validity ◽  
Chronic Obstructive ◽  
Support Needs ◽  
The Impact

BackgroundPrimary care is at the forefront of COPD management. A person-centred approach is advocated, yet patients have difficulty in articulating their needs to health care professionals (HCPs). The Support Needs Approach for Patients (SNAP) tool aims to enable patients to identify and express their support needs but its validity is unknown.AimTo establish the face, content and criterion validity of the SNAP tool in advanced COPD.MethodTwo-stage mixed method primary care study involving patients with advanced COPD, and their carers. Stage 1: Face and content validity assessed though focus groups involving patients and carers (n = 12), considering the appropriateness, relevance and completeness of the SNAP tool. Data analysed using thematic analysis within a Framework Approach. Stage 2: Content and criteria validity assessed in a postal survey through patient self-completion of the SNAP tool and disease impact measures (Chronic Respiratory Questionnaire, COPD Assessment Test, and Hospital Anxiety and Depression Scale). Content validity assessed using summary statistics; criterion validity via correlations between tool items and impact measures.ResultsThe SNAP tool has good face, content and criterion validity. Patients and carers found the tool patient-friendly and potentially useful. No items on the tool were redundant, and clear correlations were found between tool items and the majority of items/sub-scales of the impact measures.ConclusionThe SNAP tool has good face validity; content and criteria validity will be reported. It has the potential to facilitate person-centred care by enabling patients to express their support needs to HCPs. Future work will pilot SNAP in clinical practice.

scholarly journals Physicians’ decreased tendency to choose palliative care for patients with advanced dementia between 1999 and 2015

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Saila Haapasalmi ◽  
Reetta P. Piili ◽  
Riina Metsänoja ◽  
Pirkko-Liisa I. Kellokumpu-Lehtinen ◽  
Juho T. Lehto
Keyword(s):  
Decision Making ◽  
Palliative Care ◽  
Legal Protection ◽  
Postal Survey ◽  
Advanced Dementia ◽  
Background Factors ◽  
Physician Decision Making ◽  
Care Approach ◽  
Life Threatening ◽  
The Impact

Abstract Background Physicians’ decision-making for seriously ill patients with advanced dementia is of high importance, especially as the prevalence of dementia is rising rapidly, and includes many challenging ethical, medical and juridical aspects. We assessed the change in this decision-making over 16 years (from 1999 to 2015) and several background factors influencing physicians’ decision. Methods A postal survey including a hypothetical patient-scenario representing a patient with an advanced dementia and a life-threatening gastrointestinal bleeding was sent to 1182 and 1258 Finnish physicians in 1999 and 2015, respectively. The target groups were general practitioners (GPs), surgeons, internists and oncologists. The respondents were asked to choose between several life-prolonging and palliative care approaches. The influence of physicians’ background factors and attitudes on their decision were assessed. Results The response rate was 56%. A palliative care approach was chosen by 57 and 50% of the physicians in 1999 and 2015, respectively (p = 0.01). This change was statistically significant among GPs (50 vs 40%, p = 0.018) and oncologists (77 vs 56%, p = 0.011). GPs chose a palliative care approach less often than other responders in both years (50 vs. 63% in 1999 and 40 vs. 56% in 2015, p < 0.001). In logistic regression analysis, responding in 2015 and being a GP remained explanatory factors for a lower tendency to choose palliative care. The impact of family’s benefit on the decision-making decreased, whereas the influence of the patient’s benefit and ethical values as well as the patient’s or physician’s legal protection increased from 1999 to 2015. Conclusions Physicians chose a palliative care approach for a patient with advanced dementia and life-threatening bleeding less often in 2015 than in 1999. Specialty, attitudes and other background factors influenced significantly physician decision-making. Education on the identification and palliative care of the patients with late-stage dementia are needed to make these decisions more consistent.

scholarly journals Psychometric evaluation and cultural adaptation of the Spanish version of the “Scale for End-of Life Caregiving Appraisal”

2018 ◽  
Vol 17 (03) ◽  
pp. 314-321
Author(s):  
José Manuel Hernández-Padilla ◽  
Matías Correa-Casado ◽  
José Granero-Molina ◽  
Alda Elena Cortés-Rodríguez ◽  
Tamara María Matarín-Jiménez ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Construct Validity ◽  
End Of Life ◽  
Exploratory Factor Analysis ◽  
Content Validity ◽  
Criterion Validity ◽  
Spanish Version ◽  
Validity Index ◽  
Content Validity Index ◽  
The Impact

AbstractObjectiveTo translate, culturally adapt, and psychometrically evaluate the Spanish version of the “Scale for End-of Life Caregiving Appraisal” (SEOLCAS).MethodObservational cross-sectional study. Convenience sample of 201 informal end-of-life caregivers recruited in a southern Spanish hospital. The reliability of the questionnaire was assessed through its internal consistency (Cronbach's α) and temporal stability (Pearson's correlation coefficient [r] between test-retest). The content validity index of the items and the scale was calculated. Criterion validity was explored through performing a linear regression analysis to evaluate the SEOLCAS’ predictive validity. Exploratory factor analysis was used to examine its construct validity.ResultsThe SEOLCAS’ reliability was very high (Cronbach's α = 0.92). Its content validity was excellent (all items’ content validity index = 0.8–1; scale's validity index = 0.88). Evidence of the SEOLCAS’ criterion validity showed that the participants’ scores on the SEOLCAS explained approximately 79.3% of the between-subject variation of their results on the Zarit Burden Interview. Exploratory factor analysis provided evidence of the SEOLCAS’ construct validity. This analysis revealed that two factors (“internal contingencies” and “external contingencies”) explained 53.77% of the total variance found and reflected the stoic Hispanic attitude toward adversity.Significance of resultsThe Spanish version of the SEOLCAS has shown to be an easily applicable, valid, reliable, and culturally appropriate tool to measure the impact of end-of-life care provision on Hispanic informal caregivers. This tool offers healthcare professionals the opportunity to easily explore Hispanic informal end-of-life caregivers’ experiences and discover the type of support they may need (instrumental or emotional) even when there are communicational and organizational constraints.

Randomized trial of inpatient palliative care in patients hospitalized for hematopoietic stem cell transplantation (HCT).

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 103-103 ◽  
Author(s):  
Areej El-Jawahri ◽  
Thomas William LeBlanc ◽  
Harry VanDusen ◽  
Lara Traeger ◽  
Joseph A. Greer ◽  
...  
Keyword(s):  
Palliative Care ◽  
Depression Scale ◽  
Symptom Burden ◽  
Hematologic Malignancies ◽  
Linear Regression Models ◽  
Post Traumatic Stress ◽  
Hematopoietic Stem ◽  
Care Intervention ◽  
Edmonton Symptom Assessment Scale ◽  
The Impact

103 Background: During HCT, patients experience physical and psychological symptoms that negatively impact their quality of life (QOL). We assessed the impact of an inpatient palliative care intervention on patient QOL, symptom burden, and mood during HCT hospitalization and at 3 months post-HCT. Methods: We randomized 160 patients with hematologic malignancies admitted for autologous or allogeneic HCT to an inpatient palliative care intervention (n=81) integrated with transplant care compared to transplant care alone (n=79). We used the Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) to assess QOL, the Hospital Anxiety and Depression Scale (HADS) and Patient Health Questionnaire (PHQ-9) to assess mood, and Edmonton Symptom Assessment Scale (ESAS) to measure symptoms at baseline, week-2, and 3 months post-HCT. We measured post-traumatic stress (PTSD) symptoms using the PTSD checklist at baseline and 3 months post-HCT. We used linear regression models controlling for baseline values to assess the intervention effects on outcomes at week-2 and 3 months post-HCT. Results: Between 8/2014 and 1/2016, we enrolled 160/186 (86%) of potentially eligible patients. At week-2, the intervention led to improvements in QOL, depression, anxiety, and symptom burden. At 3 months post-HCT, the intervention led to improvements in QOL, depression, and PTSD [Table 1]. PHQ-9 scores at week-2 and HADS-anxiety scores at 3 months did not differ significantly. Conclusions: Palliative care improved QOL, depression, anxiety, and symptom burden in patients hospitalized for HCT with notable sustained effects 3 months post-HCT. Involvement of palliative care for patients with hematologic malignancies can improve their outcomes and substantially reduce the morbidity of HCT. Clinical trial information: NCT02207322. [Table: see text]

scholarly journals Psychometric properties of women’s satisfaction with the childbirth education class questionnaire for Iranian population

2020 ◽  
Author(s):  
Robab Hassanzadeh ◽  
Mohammad Asghari Jafarabadi ◽  
Fatemeh Abbas-Alizadeh ◽  
Shahla Meedya ◽  
Sakineh Mohammad-Alizadeh-Charandabi ◽  
...  
Keyword(s):  
Construct Validity ◽  
Content Validity ◽  
Cluster Sampling ◽  
Confirmatory Factor Analyses ◽  
Childbirth Education ◽  
Education Class ◽  
Convergent Construct Validity ◽  
The Face ◽  
Childbirth Preparation ◽  
The Impact

Abstract Background: Childbirth preparation classes can reduce pregnant women’s anxiety and fear levels by providing them with training supports. The importance of mothers’ participation in these classes, evaluation of their satisfaction with these classes, and lack of a standard instrument in Iran led to the necessity of conducting this study for the translation and psychometric analysis of the women’s satisfaction with the childbirth education class questionnaire for the population of Iranian women. Methods: The questionnaire was translated from English into Persian through the forward-backward translation method. The cluster sampling method was employed to select 205 pregnant women with gestational age of 35-37 weeks from all health complexes of Tabriz, Iran. The face, content, and construct validity of the research instrument were assessed through exploratory and confirmatory factor analyses. Internal consistency and test-retest reliability were measured to evaluate the overall reliability of the questionnaire. Results: The impact scores of all items were above 1.5. The content validity index (CVI) and content validity ratio (CVR) of the questionnaire were 0.88 and 0.94, respectively. The convergent construct validity of the whole questionnaire and those of its three subscales were confirmed through the exploratory factor analysis (EFA). The factor loadings of no items were below 0.3, and the X2⁄df ratio was smaller than 5. In addition, the RMSEA was smaller than 0.08; therefore, the overall model validity was confirmed. Cronbach’s alpha and intra-class correlation coefficient (ICC) were 0.93 and 0.96, respectively, indicating the acceptable reliability of the questionnaire. Conclusion: The Persian version of this questionnaire, entitled "Women’s Satisfaction with Childbirth Education Class" is a valid and reliable instrument for measuring Iranian women’s satisfaction with childbirth education classes.

Circumstances Related to Moral Distress in Palliative Care: An Integrative Review

2020 ◽  
pp. 104990912097882
Author(s):  
Carla Corradi-Perini ◽  
Julianna Rodrigues Beltrão ◽  
Uiara Raiana Vargas de Castro Oliveira Ribeiro
Keyword(s):  
Palliative Care ◽  
Healthcare Professionals ◽  
Moral Distress ◽  
Well Being ◽  
Integrative Review ◽  
Death Process ◽  
Communication Problems ◽  
Ethical Conflicts ◽  
Relief Of Suffering ◽  
The Face

Background: The practice of palliative care is involved with ethical conflicts related to the life-death process and relief of suffering. The inability to act in the face of such dilemmas, due to internal or external barriers, can cause moral distress in the healthcare professionals. Objective: The purpose of this integrative review is to analyze which circumstances cause moral distress in healthcare professionals who work in palliative care. Methods: An integrative review of the literature was made in the SCIELO and PubMed databases, based on the descriptors “palliative care” and “moral distress.” Articles published between 2015-2020, in Portuguese, Spanish and English were included, following the PRISMA criteria. Results: From a selection of 97 documents, 56 were completed reviewed and 23 studies were included in the review. Most articles refer to the nursing area, followed by multidisciplinary studies. The circumstances related to moral distress were identified involving: personal aspects; patients and caregivers; team; environment and organization. Communication problems, lack of resources and witnessing professionals giving false hope to patient and family members were the events related to moral distress most mentioned by the articles in the review. Recommendations for reducing and preventing moral distress include empowerment and educational programs in bioethics and palliative care. Conclusions: Moral distress is an evident phenomenon in palliative care, involving different situations that can impact on quality-of-care provided as well as the well-being of the healthcare professionals.

scholarly journals Face and content validity of the Carer Support Needs Assessment Tool (CSNAT), and feasibility of the CSNAT intervention, for carers of patients with chronic obstructive pulmonary disease

2021 ◽  
pp. 174239532199943
Author(s):  
Kerry Micklewright ◽  
Morag Farquhar
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Needs Assessment ◽  
Pulmonary Disease ◽  
Content Validity ◽  
Assessment Tool ◽  
Chronic Obstructive ◽  
Support Needs ◽  
Obstructive Pulmonary Disease ◽  
Carer Support ◽  
The Impact

Objectives Informal carers of patients with Chronic Obstructive Pulmonary Disease (COPD) have unmet support needs. Evidence relating to carers’ support needs in chronic conditions informed version 3 of the Carer Support Needs Assessment Tool (CSNAT) which forms part of an intervention to identify and address carer support needs. Aim of study: to establish the face and content validity of CSNAT v3 for use with COPD carers and explore their views on delivery of the CSNAT Intervention in practice. Methods Focus groups conducted September-October 2019 in non-clinical settings recruited eleven COPD carers (two to six participants per group). COPD patients ( n = 2) attended one group to facilitate carer attendance, the impact of which is discussed. Most participating carers were female ( n = 10); carers’ ages ranged 52–79 years. Results CSNAT v3 was easy to understand and complete, and all 15 domains were considered relevant and appropriate, suggesting good face and content validity. The demeanour, relational skills, and knowledge of the CSNAT facilitator appeared more important to carers than being a certain practitioner type. Discussion COPD carers considered the CSNAT Intervention an acceptable way of identifying and responding to their needs. The intervention could potentially be delivered through a range of services.

scholarly journals Long-term nurse–parent relationships in paediatric palliative care: a narrative literature review

2019 ◽  
Vol 25 (11) ◽  
pp. 542-550 ◽  
Author(s):  
Mandy J Brimble ◽  
Sally Anstey ◽  
Jane Davies
Keyword(s):  
Palliative Care ◽  
Literature Review ◽  
Emotional Support ◽  
Healthcare Professionals ◽  
Grey Literature ◽  
Paediatric Palliative Care ◽  
The Face ◽  
Narrative Literature ◽  
Narrative Literature Review

Background: Paediatric palliative care (PPC) is an active, total approach to the holistic care of the child and family. Close, long-lasting relationships between healthcare professionals and parents in paediatric palliative care enhance quality, provide emotional support and can influence how parents manage their role in the face of uncertainty. Aim: To present a narrative literature review of long-term relationships between children's nurses and parents in PPC settings. Methods: Six databases (CINAHL, PsycINFO, ASSIA, Scopus, Medline and BNI) were searched, identifying 35 articles. A grey literature search produced seven additional relevant items. Findings: Four themes were identified: bonds; attachments and trust; sharing the journey; going the extra mile; and boundaries and integrity. All themes revealed an element of tension between closeness and professionalism. Conclusion: Gaining a greater understanding of how closeness and professionalism are successfully managed by children's palliative care nurses could positively influence pre- and post-registration nurse education.

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