Selecting the Best Instrument to Measure Family Perceptions of End-of-Life Communication in Intensive Care Units

2019 ◽  
Vol 37 (2) ◽  
pp. 154-160
Author(s):  
Chiahui Chen ◽  
Scott T. Meier
Keyword(s):  
Intensive Care ◽  
Psychometric Properties ◽  
End Of Life ◽  
Convergent Validity ◽  
Discriminant Validity ◽  
Outcome Instrument ◽  
Clinician Communication ◽  
Family Perceptions ◽  
Eol Care

Background: Good communication with the family is a clinical imperative for high quality end-of-life (EOL) care in intensive care unit (ICU). Many interventions aim to improve EOL communication, and the choice of an outcome instrument has important implications for evaluating interventions. The purpose of this project is to search and review available instruments’ psychometric properties and determine which best measures family–clinician communication in the ICU. Method: A stepwise method was used by searching 2 databases (PsycInfo and Web of Science) to identify instruments and articles that provide information about scale psychometric properties. Instruments: Three instruments were identified, including Family Inpatient Communication Survey, Family Perception of Physician–Family Caregiver Communication, and Quality of Communication (QOC). Results: Reliability estimates were high (≥ 0.79) in all 3 instruments. The QOC’s convergent validity estimates exceed its discriminant validity values, and the QOC is an intervention-sensitive measure used to examine families’ treatment response in randomized control trials. Conclusion: Quality of Communication is the most suitable instrument to measure family’s perceptions of EOL communication in the ICU. Quality of Communication scores provide a deeper understanding of family–clinician communication and data about how to improve EOL care in ICUs.

scholarly journals Caregiver evaluation of the quality of end-of-life care (CEQUEL) scale: The caregiver’s perception of patient care near death.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 6573-6573
Author(s):  
Philip C Higgins ◽  
Holly Gwen Prigerson
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Convergent Validity ◽  
Risk Indicator ◽  
Life Care ◽  
Trauma Symptoms ◽  
Prospective Longitudinal Study ◽  
Eol Care ◽  
Prospective Longitudinal

6573 Background: End-of-life (EOL) measures are limited in capturing caregiver assessment of the quality of EOL care. None include caregiver perception of patient suffering and prolongation of death. We developed and validated the Caregiver Evaluation of Quality of End-of-Life Care (CEQUEL) scale, a more comprehensive measure of caregiver-perceived quality of EOL care. Methods: Data were derived from Coping with Cancer (CwC), a multisite, prospective, longitudinal study of advanced cancer patients and their caregivers (N=275 dyads). Caregivers were assessed before and after patient deaths. CEQUEL’s factor structure was examined; reliability was evaluated using Cronbach’s α, and convergent validity by the strength of associations between CEQUEL scores and key EOL outcomes. Results: Factor analysis revealed four distinct factors: Prolongation of Death, Perceived Suffering, Shared Decision-Making, and Preparation for the Death. Each item loaded strongly on only a single factor. The 13-item CEQUEL and its subscales showed moderate to acceptable Cronbach’s α (range: 0.52-0.78). 53% of caregivers reported patients suffering more than expected. Higher CEQUEL scores were positively associated with therapeutic alliance (r=.13; p≤.05) and hospice enrollment (z=-2.09; p≤.05), and negatively associated with bereaved caregiver regret (r=-.36, p≤.001) and trauma symptoms (z=-2.06; p≤.05). Conclusions: CEQUEL is a brief, valid measure of quality of EOL care from the caregiver’s perspective. It is the first scale to include perceived suffering and prolongation of death. If validated in future work, it may prove a useful quality indicator for the delivery of EOL care and a risk indicator for poor bereavement adjustment.

Quality of life changes and intensive care preferences in terminal cancer patients

2014 ◽  
Vol 13 (5) ◽  
pp. 1309-1316 ◽  
Author(s):  
In Cheol Hwang ◽  
Bhumsuk Keam ◽  
Young Ho Yun ◽  
Hong Yup Ahn ◽  
Young-Ae Kim
Keyword(s):  
Quality Of Life ◽  
Intensive Care ◽  
End Of Life ◽  
Cancer Patients ◽  
Medical Decision ◽  
Terminal Cancer ◽  
Terminal Cancer Patients ◽  
Eol Care ◽  
Stability Of Preferences

AbstractObjective:There is scarce research on the short-term fluctuations in end-of-life (EoL) care planning for seriously ill patients. The aim of our study was to investigate the stability of preferences regarding treatment in an intensive care unit (ICU) and identify the factors associated with changes in preferences in terms of quality of life (QoL).Method:A prospective examination on preference changes for ICU care in 141 terminal cancer patients was conducted. Patients were categorized according to their change in preference during the final two months of their lives into four categories: (1) the keep–accept group, (2) the keep–reject group, (3) the change to accept group, and (4) the change to reject group. Using multiple logistic analyses, we explored the association between patient demographics, health-related QoL, and changes in ICU preference.Results:The overall stability of ICU preferences near the end of life was 66.7% (κ = 0.33, p < 0.001). Married patients were more likely to change their preference regarding ICU care [adjusted odds ratio (aOR) toward accept 12.35, p = 0.021; aOR toward reject 10.56, p = 0.020] than unmarried patients. Patients with stable physical function tended to accept ICU care (aOR = 5.05, p = 0.023), whereas those with poor performance (aOR = 5.32, p = 0.018), worsened QoL (aOR = 8.34, p = 0.007), or non-aggravated fatigue (aOR = 8.36, p = 0.006) were more likely to not accept ICU care.Significance of results:The attitudes of terminally ill cancer patients regarding ICU care at the end of life were not stable over time, and changes in their QoL were associated with a tendency to change their preferences about ICU care. Attention should thus be paid to patients' QoL changes to improve medical decision making with regard to EoL care.

Communication in the Intensive Care Unit About the End of Life

2007 ◽  
Vol 18 (4) ◽  
pp. 406-414
Author(s):  
Patsy D. Treece
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
End Of Life ◽  
Positive Impact ◽  
Perceived Quality ◽  
Clinician Communication ◽  
End Of Life Communication

Communicating well in the intensive care unit is essential to providing quality critical care for the families of patients who are expected to die. There are many examples in the literature of how clinicians fall short of meeting these needs of families. There is also a developing body of literature describing approaches and tools that may have a positive impact on the perceived quality of end-of-life communication. The quality of clinician communication can be improved just as other skills that are important in the intensive care unit.

scholarly journals Trends in the Aggressiveness of End-of-Life Cancer Care in the State of Qatar

2016 ◽  
Vol 2 (2) ◽  
pp. 68-75 ◽  
Author(s):  
Azza A. Hassan ◽  
Hassan Mohsen ◽  
Ayman A. Allam ◽  
Pascale Haddad
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
End Of Life ◽  
Cancer Care ◽  
The State ◽  
Care Services ◽  
Palliative Care Services ◽  
Excellent Care ◽  
Eol Care

Purpose Quality of end-of-life (EOL) care is a key component of excellence in cancer care, and monitoring indicators for quality of EOL cancer care is crucial to providing excellent care. The aim of the current study is to describe the relative aggressiveness of EOL cancer care in the state of Qatar and to compare it with international figures. Methods We analyzed all deaths from cancer in Qatar between January 1, 2009 and December 31, 2013. A total of 784 eligible patients were studied to assess aggressiveness of cancer care at EOL. Results The average number of intensive care unit admissions per person decreased from 0.44 to 0.22 (P < .001) over the period of study. In addition, patients spent fewer days in the intensive care unit (2.79 to 1.82 days; P = .006) and made fewer visits to the emergency department (1.00 to 0.52 visits; P < .001) in the last 30 days of life. Fewer patients had at least one aggressive treatment measure at EOL during the 5-year period (82.3% to 71.0%; P = .038). The mean composite score for aggressiveness of EOL care decreased from 2.24 to 1.92 (P < .01). Conclusion The aggressiveness of EOL cancer care has significantly decreased over time in Qatar; however, despite this decrease, the rate is still higher than that reported internationally. The integration of community palliative care services in Qatar may further decrease the aggressiveness of cancer care at EOL.

scholarly journals Families' perception, knowledge, and psychological stressors associated with transition of care from the intensive care unit

2019 ◽  
Vol 2 (1) ◽  
pp. 53-56
Author(s):  
Gustavo Ferrer ◽  
Chi Chan Lee ◽  
Monica Egozcue ◽  
Hector Vazquez ◽  
Melissa Elizee ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Health Care Providers ◽  
Family Members ◽  
Expected Improvement ◽  
Transition Of Care ◽  
Care Providers ◽  
Icu Discharge ◽  
Family Perceptions

Background: During the process of transition of care from the intensive care setting, clarity, and understanding are vital to a patient's outcome. A successful transition of care requires collaboration between health-care providers and the patient's family. The objective of this project was to assess the quality of continuity of care with regard to family perceptions, education provided, and psychological stress during the process. Methods: A prospective study conducted in a long-term acute care (LTAC) facility. On admission, family members of individuals admitted to the LTAC were asked to fill out a 15-item questionnaire with regard to their experiences from preceding intensive care unit (ICU) hospitalization. The setting was an LTAC facility. Patients were admitted to an LTAC after ICU admission. Results: Seventy-six participants completed the questionnaire: 38% expected a complete recovery, 61% expected improvement with disabilities, and 1.3% expected no recovery. With regard to the length of stay in the LTAC, 11% expected < 1 week, 26% expected 1 to 2 weeks, 21% expected 3 to 4 weeks, and 42% were not sure. Before ICU discharge, 33% of the participants expected the transfer to the LTAC. Also, 72% did not report a satisfactory level of knowledge regarding their family's clinical condition or medical services required; 21% did not receive help from family members; and 50% reported anxiety, 20% reported depression, and 29% reported insomnia. Conclusion: Families' perception of patients' prognosis and disposition can be different from what was communicated by the physician. Families' anxiety and emotional stress may precipitate this discrepancy. The establishment of optimal projects to eliminate communication barriers and educate family members will undoubtedly improve the quality of transition of care from the ICU.

scholarly journals Development and Validation of the Adolescent Insomnia Questionnaire

2019 ◽  
Author(s):  
Maggie H Bromberg ◽  
Rocio de la Vega ◽  
Emily F Law ◽  
Chuan Zhou ◽  
Tonya M Palermo
Keyword(s):  
Psychometric Properties ◽  
Convergent Validity ◽  
Discriminant Validity ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Parent Report ◽  
Self Report ◽  
Cutoff Score ◽  
Screening Measure ◽  
Brief Screening

Abstract Objective Insomnia is a highly prevalent sleep disorder that is particularly common among adolescents with health conditions. We aimed to develop and validate a brief screening measure of insomnia in adolescents that can be used across clinical and community samples. We hypothesized that we would identify evidence supporting reliability, convergent/discriminant validity, and that we would determine preliminary clinical cutoff scores. Methods A team of experts in behavioral sleep medicine developed a 13-item brief screening measure of insomnia in adolescents (Adolescent Insomnia Questionnaire [AIQ]). We evaluated the psychometric properties of the AIQ in a sample of 315 youth (11–18 years old, Mean = 14.90, SD = 2.02; 64% female) who had chronic pain (n = 37), headache (n = 170), insomnia diagnosed by a sleep specialist (n = 22), or were otherwise healthy (n = 86). Results Using Exploratory and Confirmatory Factor Analysis, we identified three subscales consistent with major diagnostic criteria of insomnia. As expected, the measure showed strong reliability through high internal consistency (α =.91). We also found strong convergent validity through expected positive relationships between the AIQ and self-report measures of sleep disturbance, and divergent validity via weak relationships with parent-report of snoring. Results of receiver operating characteristic (ROC) identified a clinical cutoff score that may assist in clinical decision making. Conclusions We found that the AIQ has sound psychometric properties in a large heterogeneous sample of treatment-seeking youth and youth from the community. The AIQ can quickly screen adolescent insomnia and could address an important clinical need in identifying youth in need of insomnia treatment in pediatric practice settings.

scholarly journals Metamemory and aging: Psychometric properties of the Brazilian version of the Multifactorial Memory Questionnaire for elderly

2016 ◽  
Vol 10 (2) ◽  
pp. 113-126 ◽  
Author(s):  
Sharon Sanz Simon ◽  
Renata Thomas Ávila ◽  
Gilson Vieira ◽  
Cássio Machado de Campos Bottino
Keyword(s):  
Psychometric Properties ◽  
Convergent Validity ◽  
Discriminant Validity ◽  
Elderly Subjects ◽  
Subjective Memory ◽  
Memory Functioning ◽  
Brazilian Version ◽  
Good Internal Consistency ◽  
Positive Correlations ◽  
Memory Questionnaire

ABSTRACT Metamemory measures provide subjective memory information and are relevant to investigate memory ability in aging. However, there is a lack of metamemory instruments available in Brazil. Objective: The aim of this study was to examine the psychometric properties of the Brazilian version of the Multifactorial Memory Questionnaire (MMQ), which evaluates different dimensions of subjective memory functioning, such as Feelings, Abilities and Strategies used in everyday life. Methods: The MMQ was translated into Portuguese and administered to 30 Brazilian elderly subjects. The participants underwent cognitive tests, mood scales and metamemory instruments. Results: Analyses revealed good internal consistency (Cronbach's a coefficient ranged from 0.75 to 0.89) and test-retest validity for each MMQ dimensions (positive correlations between two applications ranged from 0.75 to 0.8). Convergent validity evidence for the MMQ was confirmed by significant positive correlations (0.47 to 0.68) with dimensions of the Metamemory in Adulthood scale (MIA) (i.e., the Ability, Control, Self-efficacy and Strategy dimensions). Discriminant validity revealed no associations between the MMQ and cognitive performance, suggesting a weak metamemory-objective memory correspondence. Moreover, there was a negative correlation between MMQ-Ability subscale scores and mood symptoms (-0.63 for anxious symptoms, and -0.54 for depressive symptoms); and the Brazilian MMQ was comparable with MMQ translations to other languages. Conclusion: The Brazilian MMQ exhibits good psychometric properties and appears promising for clinical and research purposes. Additional studies are needed to further examine the psychometric properties of the Brazilian MMQ in a larger sample.

scholarly journals Reliability and Validaty of St George Respiratory Questionnaire (SGRQ) into Indonesian Version

2014 ◽  
Vol 3 (3) ◽  
pp. 179
Author(s):  
Adnan Adnan ◽  
Dyah Aryani Perwitasari ◽  
Ully Adhie Mulyani
Keyword(s):  
Quality Of Life ◽  
Factor Analysis ◽  
Convergent Validity ◽  
Discriminant Validity ◽  
Special Instrument ◽  
Convergent And Discriminant Validity ◽  
Group Validity ◽  
Section Design ◽  
St George's Respiratory Questionnaire

Tuberculosis (TB) is one of the disease as the highest contributor to the disease burden in Indonesia. Tuberculosis can affect the patients’ quality of life, such as psychological, physical, and social functioning. St. George's Respiratory Questionnaire (SGRQ) is a special instrument which was widely used to measure the patients’ quality of life with respiratory disease. The objective of this study was to validate the Indonesian version of the SGRQ as instrument to collect data. A descriptive cross section design with 61 subjects was conducted at the Pulmonary Clinics and Primary Health Centers in the region of Yogyakarta within 3 months. The validation process included the known group validity, convergent and discriminant validity and factor analysis. There were 14 items question numbers which did not meet the criteria for convergent validity and 9 items which did not meet the criteria for discriminant validity. Known group validity analysis on gender showed that of the three domains of SGRQ, the activity domain gave statistically significant result. The factor analysis showed the result of Kaiser Meyer Olkin analysis (KMO) was less than 0.5. With a few modifications, the Indonesian version of SGRQ is valid and reliable for measuring quality of life in tuberculosis patients.

scholarly journals DARBUOTOJŲ PSICHOLOGINIS ĮGALINIMAS: LIETUVIŠKOJO TYRIMO METODO PSICHOMETRINĖS CHARAKTERISTIKOS

Psichologija ◽  
2013 ◽  
Vol 47 ◽  
pp. 44-60
Author(s):  
M. Tvarijonavičius ◽  
D. Bagdžiūnienė
Keyword(s):  
Intrinsic Motivation ◽  
Psychometric Properties ◽  
Convergent Validity ◽  
Discriminant Validity ◽  
Psychological Empowerment ◽  
Reliability And Validity ◽  
Future Research ◽  
Internal Reliability ◽  
Five Dimensions ◽  
Motivation Scale

Straipsnyje analizuojama darbuotojų psichologinio įgalinimo problema, pristatomas lietuviškas psichologinio įgalinimo vertinimo klausimynas ir jo psichometrinės charakteristikos. Metodas parengtas dviem etapais, naudojant empirinę skalių konstravimo strategiją. Pirmajame etape, taikant grupinio interviu ir ekspertinio vertinimo metodus, parengti psichologinio įgalinimo vertinimo teiginiai. Antrajame etape atliktas empirinis tyrimas (dalyvavo 189 tiriamieji, reprezentuojantys 8 Lietuvos organizacijas). Remiantis jo rezultatais parengtas lietuviškas psichologinio įgalinimo vertinimo klausimynas. Tiriamosios faktorių analizės metodu išskirti penki faktoriai: prasmė, entuziazmas, sprendimų priėmimas, autonomija ir pasitikėjimas kompetencija. Klausimynas pasižymi dideliu vidiniu patikimumu (bendras Cronbacho α = 0,909, atskirų subskalių nuo 0,755 iki 0,880), dideliu konvergentiniu ir diskriminantiniu konstrukto validumu tiek viso klausimyno, tiek atskirų penkių skalių lygmeniu.Pagrindiniai žodžiai: psichologinis įgalinimas, psichologinio įgalinimo klausimynas, patikimumas, validumas.EMPLOYEE PSYCHOLOGICAL EMPOWERMENT: PSYCHOMETRIC PROPERTIES OF THE LITHUANIAN QUESTIONNAIREMantas Tvarijonavičius, Dalia Bagdžiūnienė SummaryEmployee psychological empowerment is treated as a multidimensional construct manifesting in several dimensions. It has been researched for several decades using various scales depending on the definition of psychological empowerment chosen by a reasercher. However, there is a lack of widely applicable, compact instruments for a reliable and valid assessment of psychological empowerment. Furthermore, there has been a lack of empowerment research in Lithuania. Therefore, the purpose of this study is to construct a Lithuanian psychological empowerment questionnaire and to evaluate its psychometric properties (reliability and validity).The strategy of the empirical construction of a questionnaire was used. At first, statements to describe the concept of psychological empowerment were generated, using group interviews and expert evaluation. Fifteen final items were included into the Lithuanian Psychological Empowerment Questionnaire (LPEQ). Then, an empirical research was performed: 189 respondents from 8 organizations filled up the LPEQ, G.M. Spreizer (1995) Psychological Empowerment Questionnaire (PEQ), B. E. Ashforth (1990) Helplessness Scale, Intrinsic Motivation Scale (Warr et al., 1979), and socio-demografic questions.The results of the study have revealed that the LPEQ has a high internal reliability (Cronbach α = 0.909). Five factors were extracted using the exploratoryfactor analysis, three items each. Psychological empowerment was defined based on five dimensions: meaning, enthusiasm, decision making, authonomy, and trust in competence. The Cronbach α was between 0.755 and 0.880 for the dimension level. These five dimensions show support for the existing models of psychological empowerment (Spreitzer, 1995; Menon, 2001), but also they supplement these models with for instance, the dimension of enthusiasm.The convergent validity of the LPEQ was confirmed by strong correlations (p < 0.01) between the LPEQ and the PEQ subscales, and the Intrinsic Motivation Scale. It was supported by a negative correlation between the LPEQ subscales and the Helplessness Scale. Based on the analysis of correlations, the discriminant validity of the LPEQ dimensions’ levels was confirmed.In conclusion, the Lithuanian Psychological Empowerment Questionnaire (LPEQ) can be characterized as an instrument with appropriate psychometricproperties for the use in research and practice. Directions for the future research in the field have been offered.Key words: psychological empowerment, psychological empowerment questionnaire, reliability, validity.

Sign in / Sign up

Export Citation Format

Share Document