Assessing quality of care for the dying: The development and initial validation of a postal self-completion questionnaire for bereaved relatives
Assessing quality of care for the dying: The development and initial validation of a postal self-completion questionnaire for bereaved relatives
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DOI：
10.1177/0269216311424953
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发表时间：
2012-10-01
影响因子：
4.4
通讯作者：
Ellershaw, John E.
中科院分区：
文献类型：
--
作者：
Mayland, Catriona R.;Williams, Evelyn M. I.;Ellershaw, John E.
背景资料：从病人的角度来评估“临终关怀的质量”存在着实际和伦理上的困难：另一种选择是使用丧亲的观点作为“代理”措施。目前，在英国，还没有经过验证的仪器，专门检查在生命的最后几天的护理质量或利物浦护理路径（LCP）的影响垂死Patient.Aim：开发和验证一份问卷，用于评估在生命的最后几天和丧亲之痛后的短期内对患者和家庭的护理质量。设计：该工具，“评估护理和健康结果-为垂死”（ECHO-D），是在四个不同的阶段开发：1。问题表述，2.专家小组审查（n = 6），3。更广泛的观众评论（n = 25），4。试点，包括认知预测试访谈和初步的重测信度评估与丧亲（n = 80）设置：这项研究是在临终关怀和急性医院涉及医疗保健专业人员，外行成员和丧亲relatives.Results：系统和强大的问卷开发过程中产生的证据ECHO-D的脸和内容效度。然而，在试验阶段，有失去亲人的人的反应率相对较低（23.4%）。从试点的重测分析显示，13个17个关键问题的中度或良好的稳定性，虽然小样本数量有限的interpretation.Conclusions：ECHO-D是第一个专门评估“临终关怀质量”的工具，专注于生命的最后几天，并与LCP计划的使用有直接的联系。
Background: Evaluating 'quality of care for the dying' from the patients' perspective has practical and ethical difficulties: an alternative is to use bereaved relatives' views as 'proxy' measures. Currently, within the United Kingdom, there is no validated instrument which specifically examines quality of care in the last days of life or the impact of the Liverpool Care Pathway (LCP) for the Dying Patient.Aim: To develop and validate a questionnaire for use with bereaved relatives assessing the quality of care for patients and families in the last days of life and the immediate period after the bereavement.Design: The instrument, 'Evaluating Care and Health Outcomes - for the Dying' (ECHO-D), was developed in four distinct phases: 1. Question formulation, 2. Expert panel review (n = 6), 3. Wider audience review (n = 25), 4. Pilot, including cognitive pre-testing interviews and preliminary test-retest reliability assessment with bereaved relatives (n = 80)Setting: The study was conducted within a hospice and an acute hospital involving healthcare professionals, lay members and bereaved relatives.Results: The systematic and robust process of questionnaire development generated evidence for ECHO-D's face and content validity. Response rate for the pilot stage with bereaved relatives, however, was comparatively low (23.4%). Test-retest analysis from the pilot showed moderate or good stability for 13 out of 17 key questions, although small sample numbers limited the interpretation.Conclusions: ECHO-D is the first instrument specifically to assess 'quality of care for the dying', focussing on the last days of life, and has direct links with the use of the LCP Programme.