Cultural adaptation and validation of the SPICT-ES™ instrument to identify palliative care needs in Chilean older adults

Abstract

Introduction Chile presents a context of an aging population and increased life expectancy, leading to many older adults (OA) needing palliative care (PC) during the course of their illness. The SPICT-ES™ is an instrument used to clinically evaluate patients with advanced chronic illness (ACI) to detect PC needs. Validating this instrument in Chile will allow for early detection of OA at risk of clinical deterioration who require this care. Objective Adapt and validate the SPICT-ES™ instrument to identify PC needs among OA in Chile. Methodology Study following quantitative design – cross-sectional, descriptive, and developed in three stages: cultural adaptation by expert judgment; preliminary test of the SPICT-ESCH instrument to evaluate reliability and application of the SPICT-ESCH in 292 patients, to determine internal consistency and stability of the instrument. This study was done between January 2019 and July 2021. Participants in the study were nurses and OA from 5 health centers in Santiago, Chile. This study was approved by the Ethics Committee of Universidad de los Andes. Results In the cultural adaptation with content validity, following expert judgment, all items were kept. Semantic modifications were made on only three of them. A Lawshe coefficient of 84% which determined SPICT-ESCH as an acceptable instrument for the following stages of validation and reliability. The pilot for the new version in Chile, SPICT-ESCH, determined stability and consistency over time, with a Pearson correlation coefficient (ρ) of 0.9167 (p < 0.0001). In the final application of the instrument, to fortify the psychometric evaluation (n = 292) we identified 53.4% positive SPICT-ESCH. The logistical model via OR (< 0.001) showed that the items predicted the positivity of the instrument. The internal consistency obtained was 0.8662, confirming a correlation and intercorrelation between items. 100% of nurses evaluated the SPICT-ESCH as a useful and feasible instrument. Conclusion SPICT-ESCH includes all the relevant indicators for adequate clinical identification of PC needs among the Chilean OA population, who could Benefit from the early introduction of palliative support contributing to their quality of life.

Use of the supportive and palliative care indicators tool (SPICT™) for end-of-life discussions: a scoping review

“…Of the included records ten were studies conducted in European countries 20 – 22 24 30 – 33 37 38 ; seven in Asia 23 25 27 39 – 42 ; three in the USA 28 29 36 ; two in Australia 34 35 ; one in South Africa [ 43 ] one in Chile [ 26 ] and one in Peru [ 44 ], and one paper was a review performed by authors based in Switzerland [ 18 ]. Of note the systematic review and survey of European primary care GP practice to identify patients for palliative care revealed that the United Kingdom was the only European country at the time that incorporated the SPICT™ to identify palliative care needs in primary and secondary care in clinical guidelines [ 31 ].…”

“…In addition the SPICT ™ has been translated from English to Italian [SPICT-IT ™ ] [ 22 ], Spanish [SPICT-ES ™ ] [ 20 ], Swedish [ 24 ] and Japanese [SPICT-J ™ ] [ 23 ] using the Beaton protocol for cross cultural adaptation of health measures [ 45 ]. Farfán-Zuñiga and Zimmerman-Vildoso [ 26 ] established the reliability and validity of the SPICT-ES CHTM after culturally adapting the SPICT-ES ™ using the Beaton protocol. Nurses positively evaluated the feasibility of the tool.…”

Screening instruments for early identification of unmet palliative care needs: a systematic review and meta-analysis

“…Five studies reported the reliability of different versions of SPICT, with a range of 0.35-0.97 on the Kuder-Richardson formula 20, 37 38 42 a Kappa range of 0.66-0.98 36 38 42 and a Cronbach's alpha of 0.84. 63 The Content Validity Index (CVI) was only reported for the Italian-SPICT, which was 0.86. 36 One study reported a Kappa-adjusted CVI of 0.96 for the Israeli-NECPAL.…”