Development and Validation of the ACP-CAT for Assessing the Quality of Advance Care Planning Communication

组内相关 终结性评价 等级间信度 医学 一致性 同时有效性 可靠性(半导体) 预先护理计划 患者满意度 物理疗法 心理测量学 心理学 形成性评价 护理部 缓和医疗 临床心理学 内科学 评定量表 内部一致性 教育学 发展心理学 功率(物理) 物理 量子力学
作者
Jacqueline Kwan Yuk Yuen,Amy S. Kelley,Laura P. Gelfman,Elizabeth E. Lindenberger,Cardinale B. Smith,Robert M. Arnold,Brook Calton,Jane O. Schell,Stephen Berns
出处
期刊:Journal of Pain and Symptom Management [Elsevier BV]
卷期号:59 (1): 1-8.e3 被引量:8
标识
DOI:10.1016/j.jpainsymman.2019.09.001
摘要

ContextHigh-quality advance care planning (ACP) discussions are important to ensure patient receipt of goal-concordant care; however, there is no existing tool for assessing ACP communication quality.ObjectivesThe objective of this study was to develop and validate a novel instrument that can be used to assess ACP communication skills of clinicians and trainees.MethodsWe developed a 20-item ACP Communication Assessment Tool (ACP-CAT) plus two summative items. Randomized rater pairs assessed residents' performances in video-recorded standardized patient encounters before and after an ACP training program using the ACP-CAT. We tested the tool for its 1) discriminating ability, 2) interrater reliability, 3) concurrent validity, 4) feasibility, and 5) raters' satisfaction.ResultsFifty-eight pre/post-training video recordings from 29 first-year internal medicine residents at Mount Sinai Hospital were evaluated. ACP-CAT reliably discriminated performance before and after training (median score 6 vs. 11, P < 0.001). For both pre/post-training encounters, interrater reliability was high for ACP-CAT total scores (intraclass correlation coefficient or ICC = 0.83 and 0.82) and the summative items Overall impression of ACP communication skills (ICC = 0.73 and 0.80) and Overall ability to respond to emotion (ICC = 0.83 and 0.82). Concurrent validity was shown by the strong correlation between ACP-CAT total score and both summative items. Raters spent an average of 4.8 minutes to complete the ACP-CAT, found it feasible, and were satisfied with its use.ConclusionACP-CAT provides a validated measure of ACP communication quality for assessing video-recorded encounters and can be further studied for its applicability with clinicians in different clinical contexts.
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