A Practical Guide for Item Generation in Measure Development: Insights From the Development of a Patient-Reported Experience Measure of Compassion

Abstract

Background and PurposeAlthough various measure development guidelines exist, practical guidance on how to systematically generate items is nascent. This article provides practical guidance on item generation in measure development and the use of a Table of Specifications (TOS) in this process.MethodsIn addition to a review of the literature, the item generation process within an ongoing study to develop a valid and reliable patient-reported measure of compassion is provided.ResultsConsensus on an initial pool of 109 items and their response scale was achieved with the aid of a TOS.ConclusionsDynamic, experiential, and relational care constructs such as compassion lie at the heart of nursing. Practical guidance on item generation is needed to allow nurses to identify, measure, and improve compassion in research and practice.

Development and validation of a patient-reported measure of compassion in healthcare: the Sinclair Compassion Questionnaire (SCQ)

“…The SCQ contains items that cover patients’ experiences of compassion within each of the theoretical domains of the Patient Compassion Model 1 with our results showing that these domains are subsumed under a single latent construct of compassion. These results are a defining feature of reflective measures, 25 whereby individual items each reflect the underlying construct, underscoring the necessity of conducting foundational research 16 25 26 1 and initial validation studies to establish construct validity 24–26 —an essential, but overlooked stage in the development of compassion measures 11 and measure in general. 19–21 As a result, the SCQ has excellent internal consistency (Cronbach’s alpha of 0.96) and test–retest reliability (ranging from 0.74 to 0.89).…”

“…The current study began with qualitative interviews with patients to establish the transferability of the model across our study populations and focus groups with HCP, educators and administrators (n=24) to determine the feasibility, challenges, facilitators and clinical utility of the proposed measure (see online supplemental table S1 ). The results of this first study stage, 24 along with the findings of our afore-mentioned literature review and model development directly informed the item generation stage of the study, 25 in accordance with development guidelines. 20–22 Finally, the content validity of the draft measure was established through a Delphi process with international subject matter experts and patient advisors, along with cognitive interviews with patients.…”

Initial Validation of a Patient-Reported Measure of Compassion: Determining the Content Validity and Clinical Sensibility among Patients Living with a Life-Limiting and Incurable Illness

“…Prior to establishing the content validity evidence described herein, we assessed the face validity, credibility and transferability of the PCM (Figure 1) [19]. Next, seven members of the research team systematically generated initial candidate items utilizing the themes, categories, and codes of the PCM (Figure 1), Following five phases of measure development [15], the candidate items were circulated amongst the research team in additional iterations, with each member providing in-depth, written feedback on the items and their potential response scales [15]. The result was a revised item pool of 109 items [15] covering each of the domains of compassion within the PCM.…”

“…Next, seven members of the research team systematically generated initial candidate items utilizing the themes, categories, and codes of the PCM (Figure 1), Following five phases of measure development [15], the candidate items were circulated amongst the research team in additional iterations, with each member providing in-depth, written feedback on the items and their potential response scales [15]. The result was a revised item pool of 109 items [15] covering each of the domains of compassion within the PCM. This manuscript reports the content-related validity evidence of the compassion measure by assessing content relevancy, content representativeness, and content quality [20][21][22][23].…”

“…The PCM delineates the key components of compassion and their relationship to one another, including delineating it from sympathy and empathy [4,14]. With a foundational model of compassion solely from the patient perspective, we then embarked on a multi-centre study to develop and validate a patient-reported compassion measure with a two-fold purpose: a) to measure patients' experience of compassion based on the emanated behaviours, skills, and qualities of their Healthcare Providers (HCPs); and b) to determine the extent to which patients feel that the care they received was compassionate [15]. The purpose of developing a compassion measure was to provide clinicians the means to measure individual patient experiences of compassion, while also providing researchers with a gold standard measure to conduct high-quality compassion research in healthcare.…”