Table 2 Content Validation of EPCS Items
From: Adaptation and psychometric testing of the end-of-life professional caregiver survey in Jamaica
Survey Items | CVI | Expert comments | Item revision or elimination |
|---|---|---|---|
Patient- and Family-Centered Communication subscale | |||
P1. I am comfortable helping patients and families to understand a poor prognosis. | 1.00 | I am comfortable explaining to patients and their families, what it means to have a poor prognosis? Or I am comfortable helping patients, and their families understand the meaning of their prognosis? | I am comfortable helping patients and families to understand the meaning of a poor prognosis. |
P2. I am able to assist patients with serious illness and families set goals for care. | 1.00 | I am able to assist patients and their families set patient-centered goals of end-of-life care or set goals of care along the disease trajectory? | I am able to assist patients with serious illness and families set goals for care along the disease trajectory including end-of-life care. |
P3. I am comfortable talking to patients and families about personal choice and self-determination. | 1.00 | None | |
P4. I am comfortable starting and participating in discussions about resuscitation status. | 0.67 | I am comfortable discussing life-sustaining treatments with patients and their families? -I am comfortable starting and participating in discussions about resuscitation measures. | Eliminated |
P5. I can assist family members and others through the grieving process. | 1.00 | None | |
P6. I am able to document patient needs and suggested patient care interventions. | 1.00 | None | |
P7. I am comfortable talking with other health professionals about the care of dying patients. | 1.00 | The meaning of this question isn’t clear to me… it’s too open to interpretation. | |
P8. I am comfortable helping to resolve family conflicts about end-of-life care. | 0.83 | None | |
P9. I can recognize impending death (physiologic changes). | 1.00 | None | |
P10. I know how to use non-drug therapies to manage patient symptoms. | 1.00 | I think two separate questions should be asked about knowledge and comfort. I know how to use non- drug therapies to prevent and manage patient symptoms or …to use non- drug therapies for (optimum) patient symptom control? | |
P11. I am able to address patients’ and family members’ fears of getting addicted to pain medications. | 1.00 | None | |
P12. I encourage patients and families to complete advance care planning (such as a living will). | 0.83 | None | |
Cultural and Ethical Considerations subscale | |||
C1. I am comfortable dealing with ethical issues related to end-of-life/hospice/palliative care. | 1.00 | None | |
C2. I am able to deal with my feelings related to working with dying patients. | 1.00 | This question is too open to interpretation. Dealing with feelings may translate to an expert avoidant or substance misuse or abuse for an emotionally unintelligent health care provider. I’m trying to think of a suggestion… | I am able to effectively deal with my feelings (maintain self-care) related to working with dying patients. |
C3. I am comfortable caring for dying patients. | 1.00 | I am unsure of what “comfortable caring” as a competence means… Do you mean comfort as in psychological competence (as in the previous question) or knowledge or combined skillset? | I am comfortable (mentally, spiritually) caring for dying patients. |
C4. I am comfortable assessing how spiritual issues can impact the care of patients with serious illness and their families. | 1.00 | None | |
C5. I am comfortable assessing how spiritual issues can impact the care of patients with serious illness and their families. | 1.00 | This is a repeat question I believe. | I am comfortable dealing with patients’ and families’ religious and spiritual perspectives |
C6. I am comfortable providing emotional support to grieving families. | 1.00 | None | |
C7. I am comfortable providing emotional support to grieving staff members. | 1.00 | None | |
C8. I am knowledgeable about cultural factors influencing end-of-life care. | 1.00 | None | |
Effective Patient Care subscale | |||
E1. I can recognize when patients should be navigated to a hospice center for terminal care. | 0.67 | These facilities are close to non-existent in Jamaica | Eliminated |
E2. I am familiar with palliative care principles that guide health professional palliative care education. | 1.00 | None | |
E3. I am effective at helping patients and families navigate the healthcare system. | 1.00 | None | |
E4. I am familiar with the services provided by the hospice facilities in Jamaica. | 1.00 | None | |
E5. I am effective at helping to maintain continuity across care settings. | 1.00 | None | |
E6. I am confident addressing requests for assisted suicide. | 0.67 | I think the word " confident” confers some judgement and may prevent full honesty in responding. How about “comfortable” or I know how to address requests for… Does not align with Jamaican culture/legal | Eliminated |
E7. I have personal resources to help meet my needs when working with dying patients and families. | 1.00 | I am not clear on the meaning of this question | |
E8. My workplace provides resources to support staff who care for dying patients. | 1.00 | None | |