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Using Learning Outcome Measures to assess Doctoral Nursing Education
Published on: June 21, 2010
Advancing the science of outcome measurement in paediatric palliative care
Richard Harding1, Lizzie Chambers2, Myra Bluebond-Langner3
1Herbert Dunhill Chair, Professor of Palliative Care and Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute, Department of Palliative Care, Policy and Rehabilitation, King's College London.
Insights
A new person-centred outcome measure (PCOM) is needed for paediatric palliative care. This study identified key domains and implementation challenges for developing a PCOM to improve care for children and young people.
Area of Science:
- Paediatric Palliative Care
- Health Measurement
- Outcome Measurement
Background:
- Lack of validated person-centred outcome measures (PCOMs) hinders effective paediatric palliative care.
- Current tools do not adequately capture the holistic needs of children and young people in palliative care.
Framework:
- Expert group convened following COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidance.
- Elicited views on essential domains and items for a PCOM.
- Content analysis of expert group data informed tool development.
Implementation:
- Key domains identified: symptoms, education, play, social interaction, parental support, sexual health, and sibling wellbeing.
- Implementation challenges include meaningful engagement, perceived 'testing' of parents, unrealistic expectations, and proxy validity.
- Need for clear guidance on administration, interpretation, data ownership, and access.
Implications:
- This work addresses the initial step in PCOM development, focusing on face validity and acceptability.
- Provides foundational information for the first phase of tool development.
- Informs potential use and implementation strategies for a new PCOM in routine paediatric palliative care.
Background::
There is a lack of appropriate, validated person-centred outcome measures (PCOM) for paediatric palliative care in the scientific literature, and as a result there is not a tool to drive and evaluate care of children and young people.
Methods::
In line with COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidance, an expert group was convened to elicit views on the domains/items to include in a PCOM, implementation challenges and requirements for use in routine care by practitioners. Data were content analysed.
Results::
36 UK-wide clinicians, advocates, and researchers participated. 1) Items included were: specific symptoms, education, play and social interaction, parental time for partner and other children, sex and intimacy, and sibling wellbeing. 2) Implementation challenges: supporting children and young people to engage meaningfully, that the instrument could be seen as a 'test' of parents' care quality, raising unrealistic expectations, proxy validity. 3) There is a need for clear administration and interpretation guidance and for data ownership/access to be agreed.
Conclusions::
This expert meeting addressed the initial step in COSMIN guidance, informing face validity and acceptability. It provides the information necessary for the first phase of tool development and informs potential use and implementation.
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