Docstoc

Instrument

Document Sample
Instrument Powered By Docstoc
					                  Table 1 Instrument Evaluation

                      Instrument      Purpose &        Items and Domains         Question       Conceptual                  Validity                           Reliability               Responsiveness    Burden
                                     Administration                              Format             and
                                                                                                Measurement      Content               Construct      Internal        Reproducibility
                                                                                                  Model          Validity               Validity     Consistency

                   CARES             Find how          93-132 items;           Five-point       Competency-   Literature.        Correlated        Domains           Subscales:                         Time: 10-45
                   (Cancer           cancer affects    6 domains: physical,    scale plus “do   based model   Interviews with    with SCL-90,      ranged from .88    r = .84 - .95                      min;
                   Rehabilitation    psychosocial,     psychological,          you want         of coping.    patients &         KPS, DAS.         to .92             87% agreement                      Reading
                   Evaluation        physical &        medical interaction,    help: yes/no?”                 family. Expert     Good                                 n=71,                              level N/A;
                   System)           behaviors         marital, sexual,                                       review.            agreement                            time=1 week                        Acceptability
                                                       miscellaneous                                                             with                                                                    : most found
                                     Patient                                                                                     interviewers.                                                           it easy to
                                     completes                                                                                                                                                           use.
                   CARES-SF          Shortens the      38-57 items;            Five-point                     Selected from      Correlated well   Domains           Dimensions:        Find physical, Time N/A;
                   (Cancer           CARES for         5 domains:              scale plus “do                 the CARES by       with CARES,       ranged from .60    r=.69 - .92        psychosocial    Reading
                   Rehabilitation    use with          physical,               you want help                  experts            FLIC, KPS,        to .84              81%-86%           change with     level N/A;
                   Evaluation        clinical trials   psychological,          (yes/no)?”                                        DAS. Large                           agreement          time Correlated Acceptable
                   System-Short                        medical                                                                   sample sizes.                        n=120, time=10     with FLIC @ 1, N/A.
                   Form)             Patient           interaction,                                                                                                   days               7, 14 mo post-
                                     completes         marital, sexual                                                                                                                   diagnosis
                   CPNS              Measures the      51 items;               “Importance”:                  Interviews with                      Overall: 0.91                                         Time: 2-45
                   (Cancer Patient   importance of     5 domains: coping,      seven-point                    nurses,                              Importance: .83-                                      min;
                   Need Survey)      needs and the     help, information,      Likert scale;                  patients, &                          .93                                                   Reading
                                     degree to         work, and cancer        “how well                      caregivers                           How well met:                                         level N/A;
                                     which their       shock                   met”: seven-                   using                                .79-.95                                               Acceptabili
Patient General




                                     needs are met                             point Likert                   Objective                            Domain: = .88                                        ty: reported
                                                                               scale                          Content Test &                       to .92                                                no
                                     Patient                                                                  Q-sort method                                                                              problems
                                     completes                                                                                                                                                           when used.
                   CPNQ              Assesses          71 items;               Five-point                     Literature.        Discriminant      Domains           Intercorrelation                   Time: 20
                   (Cancer Patient   unmet needs       5 domains:              scale: “what                   Interviews.        validity: able to ranged from .78    all significant                    min;;
                   Need              of people with    psychological needs,    is your level                  Expert review.     distinguish       to .90             kappa > .4                         Reading
                   Questionnaire)    cancer            health info, ADLs,      of need for                    Pilot test.        patients with                        n=124,                             level: 4th or
                                                       patient care/support,   help?”                                            different disease                    time=10-14 days                    5th grade;
                                     Patient           interpersonal                                                             stages.                                                                 Acceptabili
                                     completes         communication                                                                                                                                     ty: 25%
                                                                                                                                                                                                         non-
                                                                                                                                                                                                         completion
                                                                                                                                                                                                         rate.
                   SCNS              Assesses          61 items;               Five-point       Factor        Based on                             Domain                                               Time: 20
                   (Supportive       impact of         5 domains:              scale: “what     analysis.     CPNQ.                                ranged from .87                                       min;
                   Care Needs        cancer on         psychological needs,    is your level                  Expert review.                       to .97                                                Reading
                   Survey)           lives of          health information,     of need for                    Pilot test.                                                                                level: 5th
                                     cancer            physical/daily living   help?”                                                                                                                    grade;
                                     patients          needs, patient care                                                                                                                               Acceptability
                                                       & support, and                                                                                                                                    : patients
                                     Patient           sexuality                                                                                                                                         found it
                                     completes                                                                                                                                                           understandab
                                                                                                                                                                                                         le, 35% non-
                                                                                                                                                                                                         completion.
                    Instrument      Purpose &        Items and Domains       Question       Conceptual                   Validity                             Reliability               Responsiveness     Burden
                                   Administration                            Format             and
                                                                                            Measurement       Content               Construct      Internal          Reproducibility
                                                                                              Model           Validity               Validity     Consistency

                  HCS-PF           Assesses        33 items;               Agreement                      Based on            Poor              Domains                                                 Time: N/A;
                  (Home Care       attitudes of    2 domains               with five-                     scales by           discriminant      ranged from                                              Reading
                  Study-Patient    terminally &    Satisfaction with:      point Likert                   Zyranski and        validity.         0.10-0.75                                                level: N/A;
                  Form)            chronically ill care availability,      scale                          Ware;                                                                                          Acceptability
                                   patients        care continuity, MD                                    Pilot test                                                                                     : N/A.
                                   toward          availability, MD
                                   medical care    competence, MD
                                                   personality, MD
                                   Interview;      communication,
                                   patient may     general satisfaction
                                   be able to      Preference: home
                                   complete        care, decision-
                                                   making
                  NEQ              Assess needs of 23 items;               Agreement        Factor        Interviews.                           Domains:            Cohen’s kappa                       Time: 5 min;
                  (Need            hospitalized    3 domains: helps        with yes/no      analysis.     Pilot tests.                          ranged from .69-     ranged from .54-                    Reading
                  Evaluation       cancer patients diagnosis/prognosis,    statement                                                            .81                  .94                                 level N/A;
                  Questionnaire)   in clinical     exam/treatment,                                                                                                                                       Acceptability
                                   setting         communication &                                                                                                   Time=1week                          : 63% of
                                                   relations                                                                                                                                             patients OK;
                                   Patient                                                                                                                                                               24% in-
                                   completes                                                                                                                                                             complete;
Patient General




                                                                                                                                                                                                         3% missing
                                                                                                                                                                                                         data.
                  PNAT             Screen cancer     16 items;             Five-item                      Literature.         Physical domain Domains:              Interrater                          Time: 20-30
                  (Patient Needs   patients for      3 domains:            impairment                     Clinical            correlates with ranged from .85-       reliability:                        min.;
                  Assessment       physical &        physical,             scale for each                 experience.         KPS;            .94                    Friedman: .87,                      Training
                  Tool)            psychological     psychological, and    area within                                        Psychological                          .76, .73;                           level: low;
                                   functioning       social                domain                                             with GAIS, BSI                         Spearman rank                       Acceptablity:
                                   problems                                                                                   MPAS, BDI                              order: .59- .98                     N/A.
                                                                                                                              Social with
                                   Part of                                                                                    ISEL.
                                   clinician
                                   interview
                  PNI              Measure the       48 items; 7           Five-point                     Literature.         Discriminant       > .7 for each                                          Time: N/A;
                  (Psychosocial    unmet             domains: related to   “Importance”                   Interviews.         validity:         of the first six                                         Read level:
                  Needs            psychosocial      health                scale                          Focus group.        detected the      domains.                                                 N/A;
                  Inventory)       needs of          professionals,        Five-point                                         differences                                                                Acceptabili
                                   cancer            information needs,    “Satisfaction”                                     among needs at                                                             ty: 59%
                                   patients and      related to support    scale                                              four critical                                                              non-
                                   their             networks, identify                                                       movements of                                                               response
                                   caregivers.       needs, emotional                                                         cancer                                                                     rate and the
                                                     and spiritual,                                                           trajectory.                                                                characterist
                                   Patient &         practical and                                                                                                                                       ic of the
                                   caregiver         childcare need.                                                                                                                                     non-
                                   complete                                                                                                                                                              respondents
                                                                                                                                                                                                         was
                                                                                                                                                                                                         examined.
                  Table 1 (continued)

                     Instrument        Purpose &             Items and           Question       Conceptual                    Validity                            Reliability              Responsiveness      Burden
                                      Administration         Domains             Format             and
                                                                                                Measurement        Content               Construct      Internal         Reproducibility
                                                                                                  Model            Validity               Validity     Consistency

                   PCNA               Measures the        135 items;           Ten-point                        Literature.        Correlated with   Agreement on        R = .97                             Time: 43
                   (Prostate Cancer   importance and      3 domains:           “Importance”                     Interviews         overall           classification by   time=2 weeks                        min;
                   Needs              unmet needs of      information,         scale                            using Critical     satisfaction-     three researchers                                       Reading
                   Assessment)        men with            support, and         Ten-point                        Incident           with-care.        working                                                 level: 7th
                                      prostate cancer     care delivery        “Extent Need                     Technique &                          independently                                           grade;
                                                                               Met” scale                       Nominal                                                                                      Acceptabili
                                      Patient                                                                   Group.                                                                                       ty: 11%
                                      completes                                                                 Expert review.                                                                               non-
                                                                                                                                                                                                             completion.
                   PINQ               Measures the        17 items;            Four-point       Factor          Literature.        Correlated with   Domains:                             Detected the      Time: N/A;
                   (Patient           information         2 domains:           scale            analysis.       Interviews.        RSC, State-       ranged from .88-                      changing          Reading
                   Information        need among          disease-oriented                      Similar                            Anxiety           .92;                                  needs of          level: N/A;
                   Need               cancer patients     and information                       structure was                      Inventory &       Inter-item                            patients at       Acceptabili
                   Questionnaire)     for the             about access to                       found across                       MMPI D-scale.     correlation >0.2                      three time        ty: reasons
                                      improvement of      help & solution                       Hodgkins;                                                                                  points before     to refuse:
                                      clinical practice                                         breast cancer                                                                              and after first   not wanting
                                      and research                                              patients and                                                                               treatment         to be
Patient General




                                                                                                over time.                                                                                                   reminded
                                      Patient                                                                                                                                                                of their
                                      completes                                                                                                                                                              illness,
                                                                                                                                                                                                             feeling too
                                                                                                                                                                                                             old, etc.
                   DINA               Measures the        144 items;           Check the need   Theory of       Expert review.                       Domain:             80% - 100%        Detected          Time: N/A;
                   (The Derdiarian    informational       4 domains:           present and      information                                           exceeded 0.9      agreement found   difference        reading level
                   Informational      needs of cancer     disease, personal,   rate             seeking.                                             for all domains     using McNemar     between           N/A;
                   Needs              patients            family, and social   importance on    Needs and                                                                test              control group     Acceptability
                   Assessment)                            relationship.        10-point scale   hierarchy of                                                             time=15-20 min.   and               : N/A.
                                      Interview                                                 needs.                                                                                     experimental
                                                                                                                                                                                           group
                   INM                Assess the          9 information        Control          Based on the    Literature.                          Kendall zeta:                                           Time: N/A;
                   (Information       priority of         categories.          preference       theoretical     Based on                             .95-.99.                                                Reading
                   Needs Measure)     informational                            scale; ranking   framework of    works by                             Kendall                                                 level: N/A;
                                      needs of cancer                          of               Derdiarian      Derdiarian                           coefficient of                                          Acceptabili
                                      patients                                 informational                    Expert review.                       agreement: .20-                                         ty: N/A.
                                                                               resources;                                                            .35.
                                      Patient                                  prioritization
                                      compeletes                               of
                                                                               information
                                                                               needs
                     Instrument       Purpose &              Items and           Question      Conceptual                      Validity                               Reliability               Responsiveness      Burden
                                     Administration          Domains             Format            and
                                                                                               Measurement         Content                Construct       Internal           Reproducibility
                                                                                                 Model             Validity                Validity      Consistency

                  TINQ-BC            Identify             51 items;             Five-point                     Literature.          Correlated with    Overall =.97;                                             Time: 20
                  (Toronto           information          5 domains:           “Importance”                    Nurse                the information    Domains                                                    min;;
                  Informational      needed by            diagnosis,           scale                           opinions.            scale of HOS.       ranged from .73                                          Reading
Patient General




                  Needs              women with           tests, treatments,                                                                           to .93; Correlation                                        level: N/A;
                  Questionnaire-     recent breast        physical,                                                                                    of subscales to                                            Acceptability
                  Breast Cancer)     cancer diagnosis     psychosocial                                                                                 total scale:                                               : OK
                                     to deal with                                                                                                      .38 - .88
                                     illness

                                     Patient
                                     completes
                  PACA               Assess               12 items;            Four-point                      Interviews of        Symptom scores                           Kappa ranged       Sensitivity to    Time: few
                  (Palliative Care   effectiveness of     3 domains:           scale, except                   patients.            correlated with                          from .44 –1        detected          min.;
                  Assessment )       hospital’s           symptom              five-point                                           McCorkle                                                    statistically     Training
                                     palliative care      control, insight,    scale for                                            symptom                                                     significant       level:
                                     program              and future           insight                                              distress scale                                              intervention      N/A;
                                                          placement                                                                                                                             effects           Acceptability
                                     Professional                                                                                                                                                                 : N/A.
                                     completes
                  STAS               Assess quality of    17 items;            Five-point                      Literature.          Correlated with                          Interrater         Detected          Time: 2 min.
                  (Support Team      palliative care of   8 domains:           Likert scale                    Clinical             patient & family                         reliability: 90%   improvement       for existing
                  Assessment         multi-disciplinary   pain/symptom                                         experience.          score, Karnofsky                         agreement          in palliative     patients, 5
                  Schedule)          cancer support       control, insight,                                                         score, Spitzer                           except             care              min. new
                                     teams                psychosocial,                                                             QOL index.                               predictability                       patients;
                                                          family needs,                                                             Support team                                                Evaluated 2       Training
Stage Specific




                                     Professional         home services,                                                            scores correlate                                            palliative care   level: N/A;
                                     completes            planning affairs,                                                         with patient &                                              support teams     Acceptability
                                                          support of other                                                          family scores.                                                                : N/A.
                                                          professionals,
                                                          communication
                  NEST               Measure              135 items;           Five-point      Frame for a     Literature.                             Domains:                                                  Time: N/A;
                  (The Needs         experiences of       8 domains:           Likert scale    good death.     Interviews &                            ranged from                                                Reading
                  Near the End-of-   end-of-life          patient-MD                           Factor          focus groups.                           0.63-0.85 at                                               level N/A;
                  Life Care          patients &           relations, social                    analysis.       Symptom                                 baseline and                                               Acceptabili
                  Screening Tool)    possibly assess      connection,                          Measurement     items from                              0.64-0.89 at                                               ty: 69.2%
                                     impact of            caregiving need,                     invariance      other scales.                           follow up                                                  patients
                                     interventions        psychological                        across          Pilot tests.                                                                                       found
                                                          distress,                            sociodemogra    Expert review.                                                                                     interview
                                     Interview;           spirituality,                        phic strata.                                                                                                       helpful.
                                     patient              personal                             Item response
                                     completes if         acceptance, have                     theory on the
                                     possible             purpose, clinician                   short version
                                                          communication
            Table 1 (continued)

               Instrument      Purpose &             Items and          Question       Conceptual                     Validity                            Reliability              Responsiveness       Burden
                              Administration         Domains            Format             and
                                                                                       Measurement         Content               Construct      Internal         Reproducibility
                                                                                         Model             Validity               Validity     Consistency

             FAMCARE          Measure family   20 items;              Five-point                        Interviews.        Correlated with   Overall : 0.93;    R = .92                              Time: 22
                              satisfaction with4 domains:             Likert                            Family ranking     McCusker &        Domains:           n=23,                                min;
                              advanced cancer  information            “Satisfaction                     of items.          with overall      ranged from .61-    time < 23 hrs                        Reading
                              care             giving,                scale”                            Q-sort.            satisfaction      .88                                                      level: N/A;
                                               care availability,                                                          with care                                                                  Acceptabili
                              Family           physical care,                                                              questions.                                                                 ty: N/A.
                              completes        pain control, and
                                               2 other items
             FIN              Measure needs of 20 items, 1            Ten-point        Fulfillment      Literature.       Correlated with    Overall  for                                            Time:
             (Family          cancer patient’s domain                 “importance”     theory; factor   Items from        FAMCARE.           “importance”                                             “short”;
             Inventory of     family & extent                         scale and        analysis.        original Critical                    scale: 0.83                                              Reading
             Needs)           needs are met                           met/unmet                         Care Family                                                                                   level: N/A;
                                                                      check                             Needs Inventory.                                                                              Acceptability
                              Family                                                                    Family review.                                                                                : N/A.
                              completes
             FIN-H            Measure             30 items;           Five-point       Factor           Based on FIN                         Overall            Importance                           Time: 16-30
Caregiver




             (Family          information         5 domains:          “Importance”     analysis.        Pilot test.                          ranged from .90-    subscale:                            min;
             Inventory of     needs of            surgical care       subscale and                                                           .93;                r=0.82, Need                         Reading
             Needs-           husbands of         needs,              three-point                                                            73%-87% of          Met subscale:                        level: N/A;
             Husbands)        women with          communication       “Need Met”                                                             items: item-total   r=.79                                Acceptability
                              breast cancer       with MD, family     subscale                                                               correlation 0.4-    time: < 24 hrs                       :
                                                  relations,                                                                                 0.7                                                      12 husbands
                              Husband             diagnosis/treatme                                                                                                                                   refused to
                              completes           nt specifics,                                                                                                                                       complete.
                                                  husband’s
                                                  involvement
             HCNS             Measures the        90 items;           Seven-point      Lackey-          Statements from    Psychological,    Overall : 0.93,                      Detected           Time: 30
             (Home            importance and      6 domains:          “Importance”     Wingate          patients & home    patient care,     0.98; Domains:                        changing           min;
             Caregiver Need   satisfaction of the information,        subscale and     model            caregivers.        personal and       ranged from                         caregiver needs    Reading:
             Survey)          needs of            household,          seven-point                       Expert             household         .85-.97                               at 3 time points   5th grade
                              caregivers.         patient care,       “Satisfaction”                    evaluation.        Domains                                                                    level;
                                                  personal,           subscale                          Pilot test.        correlated with                                                            Acceptabili
                              Caregiver           spiritual, and                                                           KPSS                                                                       ty:
                              completes           psychological                                                                                                                                       caregivers
                                                                                                                                                                                                      OK.
               Instrument      Purpose &              Items and          Question     Conceptual                   Validity                              Reliability              Responsiveness     Burden
                              Administration          Domains            Format           and
                                                                                      Measurement
                                                                                        Model          Content                Construct        Internal         Reproducibility
                                                                                                       Validity                Validity       Consistency

            HCS-CF            Assess attitude of   42 items;           Agreement                    Based on            Good                Domains:                                              Time: N/A;
            (Home Care        terminally &         2 domains:          with five-                   scales by           discriminant        ranged from .50-                                       Reading
            Study –           chronically ill      Satisfaction with   point Likert                 Zyranski and        validity            .85                                                    level: N/A;
            Caretaker Form)   caretakers toward    care:               scale                        Ware.                                                                                          Acceptability
                              medical care of      availability,                                    Pilot test.                                                                                    : N/A.
                              their patients       continuity,
                                                   MD availability,
                              Interview;           MD competence,
                              patient may be       MD personality,
                              able to complete     MD
                                                   communication,
Caregiver




                                                   general
                                                   satisfaction
                                                   Preference for:
                                                   home care,
                                                   decision making
            NSS               Assess the           9 items             Five-point                   Literature.         Unmet needs         Overall : 0.84;                                       Time: 15
            (Need             intensity and                            ”Felt need”                  Expert review.      correlated with     “Felt need”                                            min;
            Satisfaction      satisfaction of                          subscale and                                     overall             subscale: 0.74;                                        Reading
            Scale)            the needs of                             five-point                                       satisfaction with   “Met need”                                             level: N/A;
                              bereaved                                 “Met need”                                       care                subscale: 0.84.                                        Acceptabili
                              families                                 subscale                                                                                                                    ty: N/A.

                              Family
                              completes
            ISNQ              Assess               29 items;           Four-point                   Literature.                             Domains:                                              Time: 37
            (Information      information &        2 domains:          “Importance”                 Interviews.                             ranged from .92-                                       min;
            and Support       support needs of     information and     subscale and                                                         .95                                                    Reading
            Needs             women who have       support             Four-point                                                                                                                  level:
            Questionnaire)    primary relative                         “Need Met”                                                                                                                  “middle”
Relative




                              with breast cancer                       subscale                                                                                                                    class;
                                                                                                                                                                                                   Acceptabili
                              Self-complete                                                                                                                                                        ty:
                                                                                                                                                                                                   “several”
                                                                                                                                                                                                   reported it
                                                                                                                                                                                                   didn’t
                                                                                                                                                                                                   apply.
    Table 2 : Domain Item Distribution Across Instrument
  Instruments  CARES CARES- CPNS   CPQ   SCN   HCS   NEQ   PNAT   PNI   PCNA   PINQ   DINA   INM   TINQ-   PACA STAS   NEST   FAM    FIN   FIN   HCNS   HCS   NSS   ISNQ
                          SF              S     -PF                                                  BC                        CARE          -H          -CF
      # Items      93 - 38 - 51    71    61    33    23     16    48    135     17    144     9     51      10   17           20     20    30     89    42    20     29
       Domain      132   57
              Pain                                                                                           1    1             3                         5
    Symptom Ctrl                                                                                             7    1
          Physical   26   10         9                       6                                       11
    Cancer Shock              11
    Psychological    44   17        16    22                 5                                        5                                           30
     Psychosocial                                                                                                 2
          Spiritual                                                                                               1                               6
            Insight                                                                                          1    1
         Sexuality    8    3               3                                                   1
          Personal                                                                            1                                                  11          20
           Marital   18    6
Caregiving needs                                                                                                                           6
            Family                                                                            2      3           2
             Social                                          5                                                                            6
    Communication                    2                                                                           3      
         Planning                                                                                                 1
       Other Prof                                                                                                 2             6                  14
      Information             10    10    15                              64                                                                4                         18
  Diagnostic Info                                                               9            1      9
   Treatment Info                                                                             2     16
Investigative Info                                                                                    7
     Daily Living                          7
             Work              5                                                                                                                   12
       Household
     Activity Mgt
           Coping             16
  Future Placemt                                                                                             1                              5             7
 Sense of purpose                                                                                                                                        2
     Participation                               3                                                                              3                         8
  MD. Interaction    11    4                     2                                                                                                       4
    MD/Care                                      8                                                                              6                  16
   Availability
 MD Competence                                   4                                                                                                        4
      Patient Care                   8     8                                                                                                              4
  Continuity of C                                4                                                                                          9
       Home Care                                 4                                                                1
   Access to Care                                4
     Care delivery                                                        35                                                    2     20
           Support                                                        36                                                                                         11
         Financial                                                                                                1
              Help             9                                                 8
             Other   32   19               4                                                   2                  1

     unclear numbers of items

				
DOCUMENT INFO