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      Psychometric Properties of the ‘Patients’ Perspective of the Quality of Palliative Care Scale’

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          Abstract

          Objectives:

          Palliative care is a basic human right for all patients suffering from progressive and excruciating pain, limitations in daily activities as well as requiring constant care. The development of palliative care is always associated with the physical, psychological, social and spiritual care quality level and requires continuous evaluation by the care-receiving patients. This study aimed to determine the psychometric properties of the patients’ perspective of the quality of palliative care scale.

          Materials and Methods:

          This methodological study was conducted on 500 patients with chronic diseases admitted to the hospitals affiliated in Golestan University of Medical Sciences, between 2019 and 2020. Participants were selected through stratified sampling through proportional allocation as well as considering the bed occupancy rate in the two referral hospitals of the university. According to Wild approach, we translated the original version of the scale the patients’ perspectives of the quality of the palliative care scale with 35 items and eight subscales. Using exploratory and confirmatory factor analysis, the psychometric properties of the scale (i.e., initial reliability and face, content, convergent and construct validities) were assessed. The reliability of the scale was calculated by applying Cronbach’s alpha coefficient, McDonald’s omega coefficient and the Intraclass correlation coefficient (ICC). SPSS-16 and AMOS-24 software programs were used to analyse the data.

          Results:

          Three items were omitted after assessing the initial reliability of the translated version of the perspectives of the quality of the palliative care scale using adjusted Cronbach’s alpha. The qualitative face validity and impact score of the remaining items of the scale were confirmed by the target group. Meanwhile, a panel of experts confirmed the content validity ratio and content validity index. Convergent validity was approved by calculating the average variance extracted >0.5. Performing EFA led to the extraction of 7 subscales with 32 items. CFA and goodness of fit indices such as GFI = 0.98, CFI = 0.91, RMSEA = 0.048 and GFI = 0.97 confirmed the construct model by omitting three items. Hence, the Persian version of the patient’s perspective of the quality of palliative care scale was finalised, including seven subscales with 29 items. ICC of >0.7 represented good reliability. Moreover, Cronbach’s alpha and McDonald’s omega coefficient confirmed the internal consistency of the scale.

          Conclusion:

          Based on the findings of this study, the Persian version of the patients’ perspective of the quality of palliative care scale is introduced as a valid and reliable scale. It can accurately indicate and predict the meticulous quality of such care in hospitalised patients and can be used in the cure and care assessments in the health system.

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          Most cited references51

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          The Use of Cronbach’s Alpha When Developing and Reporting Research Instruments in Science Education

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            Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-Reported Outcomes (PRO) Measures: report of the ISPOR Task Force for Translation and Cultural Adaptation.

            In 1999, ISPOR formed the Quality of Life Special Interest group (QoL-SIG)--Translation and Cultural Adaptation group (TCA group) to stimulate discussion on and create guidelines and standards for the translation and cultural adaptation of patient-reported outcome (PRO) measures. After identifying a general lack of consistency in current methods and published guidelines, the TCA group saw a need to develop a holistic perspective that synthesized the full spectrum of published methods. This process resulted in the development of Translation and Cultural Adaptation of Patient Reported Outcomes Measures--Principles of Good Practice (PGP), a report on current methods, and an appraisal of their strengths and weaknesses. The TCA Group undertook a review of evidence from current practice, a review of the literature and existing guidelines, and consideration of the issues facing the pharmaceutical industry, regulators, and the broader outcomes research community. Each approach to translation and cultural adaptation was considered systematically in terms of rationale, components, key actors, and the potential benefits and risks associated with each approach and step. The results of this review were subjected to discussion and challenge within the TCA group, as well as consultation with the outcomes research community at large. Through this review, a consensus emerged on a broad approach, along with a detailed critique of the strengths and weaknesses of the differing methodologies. The results of this review are set out as "Translation and Cultural Adaptation of Patient Reported Outcomes Measures--Principles of Good Practice" and are reported in this document.
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              The content validity index: are you sure you know what's being reported? Critique and recommendations.

              Scale developers often provide evidence of content validity by computing a content validity index (CVI), using ratings of item relevance by content experts. We analyzed how nurse researchers have defined and calculated the CVI, and found considerable consistency for item-level CVIs (I-CVIs). However, there are two alternative, but unacknowledged, methods of computing the scale-level index (S-CVI). One method requires universal agreement among experts, but a less conservative method averages the item-level CVIs. Using backward inference with a purposive sample of scale development studies, we found that both methods are being used by nurse researchers, although it was not always possible to infer the calculation method. The two approaches can lead to different values, making it risky to draw conclusions about content validity. Scale developers should indicate which method was used to provide readers with interpretable content validity information. (c) 2006 Wiley Periodicals, Inc.
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                Author and article information

                Journal
                Indian J Palliat Care
                Indian J Palliat Care
                IJPC
                Indian Journal of Palliative Care
                Scientific Scholar
                0973-1075
                1998-3735
                09 March 2022
                24 March 2022
                Jan-Mar 2022
                : 28
                : 1
                : 64-74
                Affiliations
                [1 ]Nursing Research Center , Golestan University of Medical Sciences, Gorgan, Iran,
                [2 ]Pôle Recherche et Enseignement Universitaire , Soins Palliatifs en Société, Maison MédicaleJeanne-Garnier, Paris, France,
                [3 ]School of Nursing , Golestan University of Medical Sciences, Gorgan, Iran.
                Author notes
                [* ] Corresponding author: Amaneh Mahmoudian, Department of Nursing, Golestan University of Medical Science, Golestan, Gorgan, Iran. mahmoudianamaneh@ 123456yahoo.com
                Author information
                https://orcid.org/0000-0003-1712-3333
                https://orcid.org/0000-0002-8225-2652
                https://orcid.org/0000-0003-0767-9987
                https://orcid.org/0000-0002-0787-139x
                https://orcid.org/0000-0003-1855-8208
                Article
                10.25259/IJPC_72_2021
                10.25259/IJPC_72_2021
                9165455
                35673378
                c53f085d-faa3-42a1-94b6-ae8234b38ba1
                © 2022 Published by Scientific Scholar on behalf of Indian Journal of Palliative Care

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                : 11 September 2021
                : 16 January 2022
                Categories
                Original Article

                Anesthesiology & Pain management
                psychometrics,patients’ perspective,quality,palliative care
                Anesthesiology & Pain management
                psychometrics, patients’ perspective, quality, palliative care

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