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      Validación del cuestionario "Palliative Care Difficulties Scale (PCDS)" en población española, sobre dificultades de profesionales sanitarios en cuidados paliativos Translated title: Validation of the "Palliative Care Difficulties Scale (PCDS)" questionnaire in the spanish population about health professionals' difficulties in palliative care

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          Abstract

          RESUMEN Fundamentos: Conocer las dificultades en la aplicación de cuidados paliativos, permitiría proponer estrategias de mejora. El objetivo del estudio fue validar la traducción de la "Escala de Dificultades en Cuidados Paliativos (PCDS)", traducida y adaptada al español. Métodos: Se realizó un estudio de validación instrumental, en un hospital comarcal y centros de atención primaria de un distrito sanitario. Participaron 148 profesionales sanitarios. Mediante una encuesta, recogimos variables sociodemográficas y profesionales sobre la formación y experiencia en cuidados paliativos, así como los ítems del cuestionario PCDS. El análisis estadístico se hizo con el programa SPSS 19.0. Resultados: Comprobamos la comprensión de la traducción y retrotraducción del cuestionario en un estudio piloto con 30 profesionales. Posteriormente, encuestamos a 118 profesionales, encontrando una frecuencia de endose no superior al 51% para la validez de contenido. En cuanto a la validez de constructo, el cálculo de la adecuación muestral, mediante el índice de Kaiser-Meyer-Olkin obtuvo un valor de 0,76. En el análisis factorial por componentes principales encontramos una varianza total explicada del 73,88% con todos los ítems. La correlación de factores osciló entre 0,2 y 0,3, así que se estableció la rotación Varimax. La correlación entre los ítems de cada factor fue superior a 0,6. Para el análisis de fiabilidad, la consistencia interna obtuvo un valor alfa de Cronbach de 0,87. En el análisis de fiabilidad test-retest, la correlación Rho de Spearman para la escala fue de 0,81. Conclusiones: Disponemos de un instrumento traducido y adaptado culturalmente al español, con validez y fiabilidad adecuadas para la medición de dificultades en cuidados paliativos.

          Translated abstract

          ABSTRACT Background: Knowing the difficulties in the application of palliative care would allow us to propose improvement strategies. The objective was to determine the metric properties of the Palliative Care Difficulties Scale (PCDS) translated and adapted to Spanish. Methods: An instrumental validation study was designed in a regional hospital and primary care centers of a health district. 148 health professionals participated. Sociodemographic and professional variables were collected by a questionnaire about palliative care training and experience, as well as items from the PCDS. The statistical analysis was done with the SPSS 19.0 program. Results: It was verified the comprehension of the translation and back translation of the questionnaire, in a pilot study with 30 professionals. Subsequently, in the survey of 118 professionals, an endorsement frequency of not more than 51% was found for content validity. As for the construct validity, the calculation of the sample adequacy, using the Kaiser-Meyer-Olkin index obtained a value of 0.76. The principal component factor analysis reached a total variance of 73.88% with all items. The correlation of factors ranged from 0.2 to 0.3; so the Varimax rotation was established. The correlation between the items of each factor was higher than 0.6. For the reliability analysis, the internal consistency obtained a Cronbach alpha value of 0.87. In the test-retest reliability analysis, Spearman’s Rho correlation for the scale was 0.81. Conclusions: It was obtained an instrument translated and culturally adapted to Spanish, with adequate validity and reliability to measure difficulties in palliative care.

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          Scale validation in applied health research: tutorial for a 6-step R-based psychometrics protocol

          Background: Applied health science research commonly measures concepts via multiple-item tools (scales), such as self-reported questionnaires or observation checklists. They are usually validated in more detail in separate psychometric studies or very cursorily in substantive studies. However, methodologists advise that, as validity is a property of the inferences based on measurement in a context, psychometric analyses should be performed in substantive studies as well. Until recently, performing comprehensive psychometrics required expert knowledge of different, often proprietary, software. The increasing availability of statistical techniques in the R environment now makes it possible to integrate such analyses in applied research. Methods: In this tutorial, I introduce a 6-step protocol which allows detailed diagnosis of core psychometric properties (e.g. structural validity, internal consistency) for scales with binary and ordinal response options aiming to measure differences in degree or quantity, the most common in applied research. The protocol includes investigations of (1) item distributions and summary statistics, item properties via (2) non-parametric and (3) parametric item response theory, (4) scale structure using factor analysis, (5) reliability via classical test theory, and (6) calculation and description of global scores. I illustrate the procedure on a measure of self-reported disability, the 24-item Sickness Impact Profile Roland Scale (RM-SIP), administered in a survey of 222 chronic pain sufferers. An R Markdown script is provided that generates reproducible reports. Results: In this sample, 15 of 24 RM-SIP items formed a unidimensional ordinal scale with good homogeneity ( H  = 0.43) and reliability ( α  = .86[.84–.89]; ω  = .87[.85–.88]). The two versions were highly correlated ( r  = .96), and regression models predicting RM-SIP disability produced comparable results. Conclusions: The example analysis illustrates how psychometric properties may be assessed in substantive studies and identify avenues for measure improvement. Applied researchers can adapt this script to perform and communicate these analyses as part of questionnaire validation and substantive studies.
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            The palliative care self-reported practices scale and the palliative care difficulties scale: reliability and validity of two scales evaluating self-reported practices and difficulties experienced in palliative care by health professionals.

            The development of palliative care educational programs is ongoing in Japan. To assess the effectiveness of educational programs for general nurses, it is necessary to develop scales for evaluating them. The aims of this study were to develop two scales to measure the effectiveness of palliative care educational programs and confirm the validity and reliability of the scales. A questionnaire survey was validated with a group of 940 nurses at two facilities. The response rate was 85% (n = 797). This study used psychometric methods such as factor analysis and intra-class correlation coefficients. We selected 18 items in 6 domains, including "dying-phase care," "patient- and family-centered care," "pain," "delirium," "dyspnea," and "communication" for the Palliative Care Self-reported Practices Scale (PCPS). For this scale, the intra-class correlation was 0.64 to 0.74 in each domain. For the Palliative Care Difficulties Scale (PDCS), we selected 15 items in 5 domains, including "communication in multidisciplinary teams," "communication with the patient and family," "expert support," "alleviation of symptoms," and "community coordination." For the PCDS, the intraclass correlation was 0.61 to 0.69 in each domain. The validity and reliability of these scales were established. Therefore, the clarification of actual practices used and difficulties experienced will be possible using these scales.
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              Impact of an intensive nursing education course on nurses' knowledge, confidence, attitudes, and perceived skills in the care of patients with cancer.

              To evaluate the impact of a cancer nursing education course on RNs. Quasi-experimental, longitudinal, pretest/post-test design, with a follow-up assessment six weeks after the completion of the nursing education course. Urban, nongovernment, cancer control agency in Australia. 53 RNs, of whom 93% were female, with a mean age of 44.6 years and a mean of 16.8 years of experience in nursing; 86% of the nurses resided and worked in regional areas outside of the state capital. Scales included the Intervention With Psychosocial Needs: Perceived Importance and Skill Level Scale, Palliative Care Quiz for Nurses, Breast Cancer Knowledge, Preparedness for Cancer Nursing, and Satisfaction With Learning. Data were analyzed using multiple analysis of variance and paired t tests. Cancer nursing-related knowledge, preparedness for cancer nursing, and attitudes toward and perceived skills in the psychosocial care of patients with cancer and their families. Compared to nurses in the control group, nurses who attended the nursing education course improved in their cancer nursing-related knowledge, preparedness for cancer nursing, and attitudes toward and perceived skills in the psychosocial care of patients with cancer and their families. Improvements were evident at course completion and were maintained at the six-week follow-up assessment. The nursing education course was effective in improving nurses' scores on all outcome variables. Continuing nursing education courses that use intensive mode timetabling, small group learning, and a mix of teaching methods, including didactic and interactive approaches and clinical placements, are effective and have the potential to improve nursing practice in oncology.
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                Author and article information

                Journal
                resp
                Revista Española de Salud Pública
                Rev. Esp. Salud Publica
                Ministerio de Sanidad, Consumo y Bienestar social (Madrid, Madrid, Spain )
                1135-5727
                2173-9110
                2019
                : 93
                : e201911106
                Affiliations
                [3] Bormujos Sevilla orgnameUniversidad de Sevilla orgdiv1Centro Universitario de Enfermería "San Juan de Dios" España
                [4] Andalucía orgnameUniversidad de Sevilla orgdiv1Departamento de Medicina Preventiva y Salud Pública Spain
                [2] Sevilla orgnameServicio Andaluz de Salud orgdiv1Distrito Sanitario Málaga orgdiv2Dispositivo de Cuidados Críticos y Urgencias España
                [1] Sevilla orgnameHospital San Juan de Dios del Aljarafe orgdiv1Servicio de Medicina España
                Article
                S1135-57272019000100448 S1135-5727(19)09300000448
                d08af127-c241-4527-ad60-80290b9d7d12

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 International License.

                History
                : 19 May 2019
                : 18 October 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 20, Pages: 0
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                SciELO Public Health

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                Terminal care,Estudios de validación,Cuidado terminal,Validation studies,Cuidados paliativos,Palliative care,Enfermería de cuidados paliativos al final de la vida,Palliative medicine,Medicina paliativa,Palliative care nursing at the end of life

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