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Initial validation of a patient-reported measure of compassion: Determining the content validity and clinical sensibility among patients living with a life-limiting and incurable illness

Published on Jan 22, 2020in The Patient: Patient-Centered Outcomes Research2.673
· DOI :10.1007/s40271-020-00409-8
Shane Sinclair16
Estimated H-index: 16
(U of C: University of Calgary),
Priya Jaggi (U of C: University of Calgary)+ 5 AuthorsCarlo Leget15
Estimated H-index: 15
(University of Humanistic Studies)
Abstract
Although compassionate care is considered a cornerstone of quality palliative care, there is a paucity of valid and reliable measures to study, assess, and evaluate how patients experience compassion/compassionate care in their care. The aim was to develop a patient-reported compassion measure for use in research and clinical practice with established content-related validity evidence for the items, question stems, and response scale. Content validation for an initial 109 items was conducted through a two-round modified Delphi technique, followed by cognitive interviews with patients. A panel of international Subject Matter Experts (SMEs) and a Patient Advisory Group (PAG) assessed the items for their relevancy to their associated domain of compassion, yielding an Item-level Content Validity Index (I-CVI), which was used to determine content modifications. The SMEs and the PAG also provided narrative feedback on the clarity, flow, and wording of the instructions, questions, and response scale, with items being modified accordingly. Cognitive interviews were conducted with 16 patients to further assess the clarity, comprehensibility, and readability of each item within the revised item pool. The first round of the Delphi review produced an overall CVI of 72% among SMEs and 80% among the PAG for the 109 items. Delphi panelists then reviewed a revised measure containing 84 items, generating an overall CVI of 84% for SMEs and 86% for the PAG. Sixty-eight items underwent further testing via cognitive interviews with patients, resulting in an additional 14 items being removed. Having established this initial validity evidence, further testing to assess internal consistency, test–retest reliability, factor structure, and relationships to other variables is required to produce the first valid, reliable, and clinically informed patient-reported measure of compassion.
  • References (36)
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References36
Newest
#1Shane Sinclair (U of C: University of Calgary)H-Index: 16
#2Priya Jaggi (U of C: University of Calgary)
Last. Lena Cuthbertson (British Columbia Ministry of Health)H-Index: 1
view all 5 authors...
BACKGROUND AND PURPOSE: Although various measure development guidelines exist, practical guidance on how to systematically generate items is nascent. This article provides practical guidance on item generation in measure development and the use of a Table of Specifications (TOS) in this process. METHODS: In addition to a review of the literature, the item generation process within an ongoing study to develop a valid and reliable patient-reported measure of compassion is provided. RESULTS: Consen...
1 CitationsSource
#1Shane Sinclair (U of C: University of Calgary)H-Index: 16
#2Priya Jaggi (U of C: University of Calgary)
Last. Pavneet Singh (U of C: University of Calgary)H-Index: 6
view all 6 authors...
A lack of evidence and psychometrically sound measures of compassion necessitated the development of the first known, empirically derived, theoretical Patient Compassion Model (PCM) generated from qualitative interviews with advanced cancer inpatients. We aimed to assess the credibility and transferability of the PCM across diverse palliative populations and settings. Semi-structured, audio-recorded qualitative interviews were conducted with 20 patients with life-limiting diagnoses, recruited fr...
Source
#1Shane Sinclair (U of C: University of Calgary)H-Index: 16
#2Lara B. Russell (UVic: University of Victoria)H-Index: 4
Last. Richard Sawatzky (Trinity Western University)H-Index: 20
view all 5 authors...
Background There is international concern about the lack of compassion in healthcare systems. A valid and reliable tool for measuring compassion in healthcare systems and educational institutions is required. This comprehensive and critical narrative synthesis identified and compared existing measures of compassionate care in clinical settings.
15 CitationsSource
#1Shane Sinclair (U of C: University of Calgary)H-Index: 16
#2Kate Beamer (U of C: University of Calgary)H-Index: 2
Last. Neil A. Hagen (U of C: University of Calgary)H-Index: 38
view all 7 authors...
Background:Compassion is considered an essential element in quality patient care. One of the conceptual challenges in healthcare literature is that compassion is often confused with sympathy and em...
48 CitationsSource
#1Charlotte Kingsley (Royal Free London NHS Foundation Trust)H-Index: 1
#2Sanjiv Patel (UCL: University College London)H-Index: 1
22 CitationsSource
#1Youngjin Lee (KU: Korea University)H-Index: 4
#2GyeongAe Seomun (KU: Korea University)H-Index: 8
Abstract Aim To develop and psychometrically validate the Compassion Competence Scale. Background Compassion is a vital asset in the nursing profession; thus, it is necessary to develop a suitable instrument for assessment. Methods The 49-item preliminary instrument was developed using concept analysis (hybrid model). Content and face validity were confirmed by 10 experts and 10 nurses, respectively, and the number of items was reduced to 18. The tool was tested on 660 nurses working at three te...
12 CitationsSource
#1Shane Sinclair (U of C: University of Calgary)H-Index: 16
#2Susan McClementH-Index: 33
Last. Harvey Max Chochinov (UM: University of Manitoba)H-Index: 45
view all 7 authors...
Context. Compassion is frequently referenced as a hallmark of quality care by patients, health care providers, health care administrators, and policy makers. Despite its putative centrality, including its institution in recent health care reform, an empirical understanding based on the perspectives of patients, the recipients of compassion, is lackingdmaking compassion one of the most referenced yet poorly understood elements of quality care. Objectives. The objective of this study was to invest...
48 CitationsSource
#1Shane Sinclair (U of C: University of Calgary)H-Index: 16
#2Jill M. Norris (U of C: University of Calgary)H-Index: 65
Last. Shelley Raffin Bouchal (U of C: University of Calgary)H-Index: 7
view all 8 authors...
Recent concerns about suboptimal patient care and a lack of compassion have prompted policymakers to question the preparedness of clinicians for the challenging environment in which they practice. Compassionate care is expected by patients and is a professional obligation of clinicians; however, little is known about the state of research on clinical compassion. The purpose of this scoping review was to map the literature on compassion in clinical healthcare. Searches of eight electronic databas...
80 CitationsSource
#1Beth A. Lown (Harvard University)H-Index: 17
#2Steven Muncer (Teesside University)H-Index: 30
Last. Raymond Chadwick (Teesside University)H-Index: 3
view all 3 authors...
Abstract Objective Assess psychometric characteristics of an instrument to measure patient ratings of treating physicians’ compassionate care in a recent hospitalization. Methods We used Cronbach's alpha to examine scale reliability, exploratory and confirmatory factor analysis to examine scale structure of two sets of items on compassionate care. We used Mokken analysis to determine if items in each set belonged to a unidimensional scale. Results Results indicated that both sets of items had st...
17 CitationsSource
#1Willem E. SarisH-Index: 32
48 CitationsSource
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