The Patient Dignity Inventory: A Novel Way of Measuring Dignity-Related Distress in Palliative Care
The Patient Dignity Inventory: A Novel Way of Measuring Dignity-Related Distress in Palliative Care
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DOI：
10.1016/j.jpainsymman.2007.12.018
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发表时间：
2008-12-01
影响因子：
4.7
通讯作者：
Murray, Alison
中科院分区：
文献类型：
--
作者：
Chochinov, Harvey Max;Hassard, Thomas;Murray, Alison
高质量的姑息治疗取决于对濒临死亡的病人所面临的痛苦的深刻理解。然而，社会心理、存在和精神痛苦的许多方面往往被忽视。本研究的目的是测试一种新的心理测量-病人尊严清单（PDI）-旨在衡量各种来源的尊严相关的困扰患者接近生命的尽头。使用标准的工具开发技术，本研究探讨了表面效度，内部一致性，重测信度，因素结构和并行效度的PDI的25个项目的PDI代来自一个模型的尊严在绝症。为了建立其基本的心理测量学特性，对253名接受姑息治疗的患者进行了PDI，沿着其他措施，以解决临终病人尊严模型中确定的问题。PDI的Cronbach系数α为0.93;测试=重测信度为r = 0。85.因子分析得出了一个五因素的解决方案;因子标签包括症状困扰，潜在困扰，依赖，心灵平静和社会支持，占总方差的58%。证据concurerrent有效性的报告之间的显着关联，PDI因素和并发措施的困扰。PDI是一个有效和可靠的新工具，它可以帮助临床医生定期检测临终尊严相关的痛苦。确定这些来源的痛苦是理解人类痛苦的关键一步，应该帮助临床医生提供高质量，尊严维护临终关怀。疼痛症状管理杂志2008; 36：559 - 571。(c)2008年美国癌症疼痛缓解委员会。由爱思唯尔公司出版All rights reserved.
Quality palliative care depends on a deep understanding of distress facing patients nearing death. Yet, many aspects of psychosocial, existential and, spiritual distress are often overlooked. The aim, of this study was to test a novel psychometric-the Patient Dignity Inventory (PDI)-designed to measure various sources of dignity-related distress among patients nearing the end of life. Using standard instrument development techniques, this study examined the face validity, internal consistency, test-retest reliability, factor structure and concurrent validity of the PDI The 25-items of the PDI dei derive from a model of dignity in the terminally ill. To establish its basic psychometric properties, the PDI was administered to 253 patients receiving palliative care, along with other measures addressing issues identified within the Dignity Model in the Terminally Ill. Cronbach's coefficient alpha for the PDI was 0.93; the test=retest reliability was r = 0. 85. Factor analysis resulted in a five-factor solution; factor labels include Symptom Distress, Existential Distress, Dependency, Peace of Mind, and Social Support, accounting for 58% of the overall variance. Evidence for concuerrent validity was reported by way of significant associations between, PDI factors and concurrent measures of distress. The PDI is a valid and reliable new instrument, which could assist, clinicians to routinely detect end-of-life dignity-related distress. Identifying these sources distress is a critical step toward understanding human suffering and should help clinicians deliver quality, dignity-conserving end-of-life care. J Pain Symptom Manage 2008;36: 559-571. (c) 2008 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.