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Published on: August 1, 2019
[Design and validation of an instrument about quality of the advance care planning for professionals]
Ángel Alfredo Martínez Ques1, Beatriz Braña Marcos2, Concepción Martín Arribas3
1Área Sanitaria de Orense, Verín y Barco de Valdeorras, Servicio Gallego de Salud (Sergas), Orense, España; Instituto de Investigación Sanitaria Galicia Sur (IIS Galicia Sur), Vigo, España.
Objective:
To develop a questionnaire aimed to measure the quality of the advance care planning process in healthcare professionals and to assess its psychometric quality.
Method:
Instrumental questionnaire validation study.
Scope:
primary care centers and outpatients clinics from general hospitals in Ferrol, Ourense, Monforte-Lugo and Health Area V of the Health Service of Asturias.
Participants:
physicians and nurses. Phases: (1) design of the first version of the questionnaire using the Delphi technique; (2) construction of the second version of 21 items, after judges' agreement and Kendall's W test; (3) pilot study: internal consistency using Cronbach's alpha and omega coefficient, retest-test by Pearson's correlation coefficient; (4) validation: Barlett's spherity test and Kaiser-Meyer-Olkin measurement, exploratory factor analysis with varimax rotation and study of the dimensions of the questionnaire (number, CCI and correlation), internal consistency using Cronbach's alpha.
Results:
Pilot study with 28 professionals. Reliability ɷ=0.917, α=0.841, and test-retest correlation coefficient of 0.785 (95% confidence interval: 0.587-0.894; p<0.001). Validation of the questionnaire (21 items) in 204 professionals. Ítem analysis and exploratory factor analysis (Barlett's test [χ2=1298,789] and KMO=0.808; p<0.001) yielded a five-factor model explaining 64.377% of the total variance, with 18 items grouped into 5 dimensions (information, preferences, behavioral intention, training and communication). Cronbach's alpha of the global questionnaire was 0.841.
Conclusions:
The ProPAD-pro questionnaire has showed to be a valid and reliable instrument to assess the quality of the advance care planning process.
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