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Development and psychometric evaluation of patient needs assessment in palliative care (PNAP) instrument

Published online by Cambridge University Press:  08 April 2015

Radka Buzgova ,
Radka Kozakova ,
Lucie Sikorova ,
Renata Zelenikova  and
Darja Jarosova
Radka Buzgova*
Affiliation:
Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Czech Republic
Radka Kozakova
Affiliation:
Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Czech Republic
Lucie Sikorova
Affiliation:
Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Czech Republic
Renata Zelenikova
Affiliation:
Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Czech Republic
Darja Jarosova
Affiliation:
Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Czech Republic
*
Address correspondence and reprint requests to: Radka Buzgova, Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Syllabova 19, Ostrava 700 30, Czech Republic. E-Mail: radka.buzgova@osu.cz
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Abstract

Objective:

Although assessment of palliative patients' needs is a key issue in palliative care, a suitable instrument for identification of such needs is not available in Central European countries. Our objectives were to produce an adequate tool for identifying the importance and satisfaction of palliative patients' needs and to verify its psychometric properties.

Method:

The patient needs assessment in palliative care (PNAP) instrument was constructed based on a literature review and qualitative research (focus groups, n = 5). The psychometric properties of the questionnaire were verified by a cross-sectional study. The convergent validity of the questionnaire was determined by confirmatory factor analysis. Furthermore, internal consistency, test–retest reliability, and construct validity were also tested. The qualitative research group comprised 30 participants (27 experts in palliative care, 1 patient, and 2 family members). Psychometric properties were evaluated in a group of 349 hospital inpatients terminally ill with chronic disease or cancer and receiving palliative care.

Results:

Based on the qualitative data analysis, a questionnaire was constructed that contained 42 items grouped into 5 domains. When testing the psychometric properties of the questionnaire, a new model containing 40 items in 7 domains was produced. Cronbach's α for the entire PNAP questionnaire was 0.89 on the importance scale and 0.80 on the satisfaction scale. Test–retest reliability was higher than 0.7 for all domains in both scales.

Significance of Results:

The results of tests on the psychometric properties of the PNAP questionnaire showed at least satisfactory validity and reliability, and it can be employed to assess the needs of palliative care patients in Central European countries.

Keywords

Palliative careNeeds assessmentPatients
Type
Original Articles
Information
Palliative & Supportive Care , Volume 14 , Issue 2: Measurement Development in Palliative and Supportive Care , April 2016 , pp. 129 - 137
Copyright
Copyright © Cambridge University Press 2015 

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References

REFERENCES

Aaronson, N., Alonso, J., Burnam, A., et al. (2002). Assessing health status and quality-of-life instruments: Attributes and review criteria. Quality of Life Research, 11, 193–205.Google Scholar
Barrett, P. (2007). Structural equation modeling: Adjudging model fit. Personality and Individual Differences, 42, 815–824.CrossRefGoogle Scholar
Bonevski, B., Sanson-Fisher, R., Girgis, A., et al. (2000). Evaluation of an instrument to assess the needs of patients with cancer. Cancer, 88, 217–225.Google Scholar
Bužgová, R., Hajnová, E. & Sikorová, L. (2013). Pilotní testování dotazníku PNAP „Hodnocení potřeb pacientů v paliativní péči.“ Ošetřovatelství a Porodní Asistence, 4, 628–633.Google Scholar
Carslon, M.D., Morrison, R.S. & Bradley, E.H. (2008). Improving access to hospice care: Informing the debate. Journal of Palliative Medicine, 11, 438–443.Google Scholar
Coyle, N., Goldstein, M.L., Passik, S., et al. (1996). Development and validation of a patient needs assessment tool (PNAT) for oncology clinicians. Cancer Nursing, 19, 81–92.CrossRefGoogle ScholarPubMed
Crooks, D.L., Whelan, T.J., Reyno, L., et al. (2004). The Initial Health Assessment: An intervention to identify the supportive care needs of cancer patients. Supportive Care in Cancer, 12, 19–24.Google Scholar
Cull, A., Stewart, M. & Altman, D.G. (1995). Assessment of and intervention for psychosocial problems in routine oncology practice. British Journal of Cancer, 72, 229–235.Google Scholar
Currow, D.C., Agar, M., Sanderson, C., et al. (2008). Populations who die without specialist palliative care: Does lower uptake equate with unmet need? Palliative Medicine, 22, 43–50.CrossRefGoogle ScholarPubMed
Davidson, P., Cockburn, J., Daly, J., et al. (2004). Patient-centered needs assessment: Rationale for a psychometric measure for assessing needs in heart failure. The Journal of Cardiovascular Nursing, 19, 164–171.CrossRefGoogle ScholarPubMed
Davies, E. & Higginson, I.J. (2005). Systematic review of specialist palliative day care for adults with cancer. Supportive Care in Cancer, 13, 607–627.Google Scholar
Deeken, J.F., Taylor, K.L., Mangan, P., et al. (2003). Care for the caregivers: A review of self-report instruments developed to measure the burden, needs, and quality of life of informal caregivers. Journal of Pain and Symptom Management, 26, 922–953.Google Scholar
Diwan, S. & Moriarty, D.G. (1995). A conceptual framework for identifying unmet health care needs of community dwelling elderly. The Journal of Applied Gerontology, 14, 47–63.Google Scholar
Edmonds, P., Karlsen, S., Khan, S., et al. (2001). A comparison of the palliative care needs of patients dying from chronic respiratory diseases and lung cancer. Palliative Medicine, 15, 287–295.Google Scholar
Emanuel, L.L., Alpert, H.R. & Emanuel, E.E. (2001). Concise screening questions for clinical assessments of terminal care: The needs near the end-of-life care screening tool. Journal of Palliative Medicine, 4, 465–474.Google Scholar
Ewing, G. & Grande, G. (2013). Development of a Carer Support Needs Assessment Tool (CSNAT) for end-of-life care practice at home: A qualitative study. Palliative Medicine, 27, 244–256.Google Scholar
Fayers, P.M., Aaronson, N.K., Bjordal, K., et al. (2001). The EORTC QLQ–C30 scoring manual, 3rd. ed.Brussels: European Organisation for Research and Treatment of Cancer.Google Scholar
Feeny, D., Farris, K., Côté, I., et al. (2005). A cohort study found that the RAND–12 and Health Utilities Index Mark 3 demonstrated construct validity in high-risk primary care patients. Journal of Clinical Epidemiology, 58, 138–141.Google Scholar
Fitzsimons, D., Mullan, D., Wilson, J.S., et al. (2007). The challenge of patients' unmet palliative care needs in the final stages of chronic illness. Palliative Medicine, 21, 313–322.Google Scholar
Fortner, B., Okon, T., Schwartzberg, L., et al. (2003). The Cancer Care Monitor: Psychometric content evaluation and pilot testing of a computer administered system for symptom screening and quality of life in adult cancer patients. Journal of Pain and Symptom Management, 26, 1077–1092.Google Scholar
Frankl, V. (1959). Man's search for meaning. New York: Random House.Google Scholar
Ganz, P.A., Schag, C.A., Lee, J.J., et al. (1992). The CARES: A generic measure of health-related quality of life for patients with cancer. Quality of Life Research, 1, 19–29.CrossRefGoogle Scholar
Gates, M.F., Lackey, N.R. & White, M.R. (1995). Needs of hospice and clinic patients with cancer. Cancer Practice, 3, 226–232.Google Scholar
Grimshaw, J.M., Winkens, R.A., Shirran, L., et al. (2005). Interventions to improve outpatient referrals from primary care to secondary care. The Cochrane Database of Systematic Reviews, 20, 1–55.Google Scholar
Holtom, N. & Barraclough, J. (2000). Is the Hospital Anxiety and Depression Scale (HADS) useful in assessing depression in palliative care? Palliative Medicine, 14, 219–220.Google Scholar
Hooper, D., Coughlan, J. & Mullen, MR. (2008). Structural equation modeling: Guidelines for determining model fit. The Electronic Journal of Business Research Methods, 6, 53–60.Google Scholar
Hu, L & Bentler, P.M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6, 1–55.CrossRefGoogle Scholar
Kellehear, A. (2000). Spirituality and palliative care: A model of needs. Palliative Medicine, 14, 149–155.Google Scholar
Liang, L.P., Dunn, S.M., Gorman, A., et al. (1990). Identifying priorities of psychosocial need in cancer patients. British Journal of Cancer, 62, 1000–1003.CrossRefGoogle ScholarPubMed
Lidstone, V., Butters, E., Seed, P.T., et al. (2003). Symptoms and concerns amongst cancer outpatients: Identifying the need for specialist palliative care. Palliative Medicine, 17, 588–595.Google Scholar
McIllmurray, M.B., Francis, B., Harman, J.C., et al. (2003). Psychosocial needs in cancer patients related to religious belief. Palliative Medicine, 17, 49–54.Google Scholar
Mitchell, A.J., Meader, N. & Symonds, P. (2010). Diagnostic validity of the Hospital Anxiety and Depression Scale (HADS) in cancer and palliative settings: A meta-analysis. Journal of Affective Disorders, 126, 335–348.Google Scholar
Nešpor, Z.R. (2012). Náboženství a ateismus v současné české společnosti ve světle statistických a sociologických výzkumů. Salve—Revue pro Teologii a Duchovní Život, 22, 7–20.Google Scholar
Osse, B.H., Vernooij-Dassen, M.J., de Vree, B.P., et al. (2000). Assessment of the need for palliative care as perceived by individual cancer patients and their families: A review of instruments for improving patient participation in palliative care. Cancer, 88, 900–911.Google Scholar
Osse, B.H., Vernooij-Dassen, M.J., Schadé, E., et al. (2007). A practical instrument to explore patients' needs in palliative care: The Problems and Needs in Palliative Care Questionnaire, short version. Palliative Medicine, 21, 391–399.CrossRefGoogle ScholarPubMed
Peterson, R.A. (1994). A meta-analysis of Cronbach's coefficient alpha. Journal of Consumer Research, 21, 381–391.Google Scholar
Richardson, A., Sitzia, J., Brown, V., et al. (2005). Patients' needs assessment tools in cancer care: Principles and practice, 1st ed.London: King's College London.Google Scholar
Sanson-Fisher, R., Girgis, A., Boyes, A., et al. (2000). The unmet supportive care needs of patients with cancer: Supportive Care Review Group. Cancer, 88, 226–237.3.0.CO;2-P>CrossRefGoogle ScholarPubMed
Scott, P.A., Välimäki, M., Leino-Kilpi, H., et al. (2003). Perceptions of autonomy in the care of elderly people in five European countries. Nursing Ethics, 10, 28–38.Google Scholar
Sepúlveda, C., Marlin, A., Yoshida, T., et al. (2002). Palliative care: The World Health Organization's global perspective. Journal of Pain and Symptom Management, 24, 91–96.Google Scholar
Soothill, K., Morris, S.M., Harman, J., et al. (2001). The significant unmet needs of cancer patients: Probing psychosocial concerns. Supportive Care in Cancer, 9, 597–605.Google Scholar
Steiger, J.H. (2007). Understanding the limitations of global fit assessment in structural equation modeling. Personality and Individual Differences, 42, 893–898.Google Scholar
Streiner, D.L. & Norman, G.R. (2003). Health measurement scales: A practical guide to their development and use, 3rd ed.New York: Oxford University Press.Google Scholar
Tamburini, M., Gangeri, L., Brunelli, C., et al. (2000). Assessment of hospitalised cancer patients' needs by the Needs Evaluation Questionnaire. Annals of Oncology, 11, 31–37.Google Scholar
Terwee, C.B., Bot, S.D., de Boer, M.R., et al. (2007). Quality criteria were proposed for measurement properties of health status questionnaires. Journal of Clinical Epidemiology, 60, 34–42.CrossRefGoogle ScholarPubMed
Thomas, C., Soothill, K., McIllmurray, M., et al. (2001). What are the psychosocial needs of cancer patients and their main carers? A study of user experience of cancer services with particular reference to psychosocial need. Lancaster, England: Lancaster University, The Institute for Health Research.Google Scholar
Tomágová, M. & Bóriková, I. (2008). Potreby v ošetrovateľstve, 1 vyd. Martin: Osveta.Google Scholar
Waller, A., Girgis, A., Currow, D., et al. (2008). Development of the palliative care needs assessment tool (PC–NAT) for use by multidisciplinary health professionals. Palliative Medicine, 22, 956–964.CrossRefGoogle Scholar
Waller, A., Girgis, A., Lecathelinais, C., et al. (2010). Validity, reliability and clinical feasibility of a needs assessment tool for people with progressive cancer. Psycho-Oncology, 19, 726–733.Google Scholar
Ware, J.E. & Gandek, B. (1998). Methods for testing data quality, scaling assumptions, and reliability: The IQOLA Project approach. An International quality of life assessment. Journal of Clinical Epidemiology, 51, 945–952.Google Scholar
Weissman, D.E. & Meier, D.E. (2011). Identifying patients in need of a palliative care assessment in the hospital setting: A consensus report from the Center to Advance Palliative Care. Journal of Palliative Medicine, 14, 17–23.Google Scholar
Wen, K.Y. & Gustafson, D.H. (2004). Needs assessment for cancer patients and their families. Health and Quality of Life Outcomes, 2, 11.Google Scholar
Wijk, H. & Grimby, A. (2008). Needs of elderly patients in palliative care. The American Journal of Hospice & Palliative Care, 25, 106–111.Google Scholar
Wheaton, B., Muthén, B., Alwin, D.F., et al. (1977). Assessing reliability and stability in panel models. Sociological Methodology, 8, 84–136.Google Scholar
Zigmond, A.S. & Snaith, R.P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychologica Scandinavia, 67, 361–370.Google Scholar