IDentification of patients in need of general and specialised PALLiative care (ID-PALL©): item generation, content and face validity of a new interprofessional screening instrument

Abstract

Background: Early identification of patients requiring palliative care is a major public health concern. A growing number of instruments exist to help professionals to identify these patients, however, thus far, none have been thoroughly assessed for criterion validity. In addition, no currently available instruments differentiate between patients in need of general vs. specialised palliative care, and most are primarily intended for use by physicians. This study aims to develop and rigorously validate a new interprofessional instrument allowing identification of patients in need of general vs specialised palliative care. Methods: The instrument development involved four steps: i) literature review to determine the concept to measure; ii) generation of a set of items; iii) review of the initial set of items by experts to establish the content validity; iv) administration of the items to a sample of the target population to establish face validity. We conducted a Delphi process with experts in palliative care to accomplish step 3 and sent a questionnaire to nurses and physicians non-specialised in palliative care to complete step 4. The study was conducted in the French and Italian-speaking regions of Switzerland. An interdisciplinary committee of clinical experts supervised all steps. Results: The literature review confirmed the necessity of distinguishing between general and specialised palliative care needs and of adapting clinical recommendations to these different needs. Thirty-six nurses and physicians participated in the Delphi process and 28 were involved in the face validity assessment. The Delphi process resulted in two lists: a 7-item list to identify patients in need of general PC and an 8-item list to identify specialised PC needs. The content and face validity were deemed to be acceptable by both the expert and target populations.

What makes palliative care needs “complex”? A multisite sequential explanatory mixed methods study of patients referred for specialist palliative care

“…We only analysed needs of those referred to hospice; future work might usefully compare the needs of those referred and those who were not referred, so that care trajectories are better understood. The ID-Pall tool has recently been developed to distinguish between needs that can be provided by non-SPC providers versus SPC [37], further validation and testing in diverse settings is now required.…”

What Makes Palliative Care Needs “Complex”?: A Multisite Sequential Explanatory Mixed Methods Study of Patients Referred to Specialist Palliative Care

“…We only analysed needs of those referred to hospice; future work might usefully compare the needs of those referred and those who were not referred, so that care trajectories are better understood. The ID-Pall tool has recently been developed to distinguish between needs that can be provided by non-SPC providers versus SPC, 33 further validation and testing in diverse settings is now required.…”

Methods used to identify the prevalence of palliative care needs: An integrative review

“…Early identification of people with PC needs is essential if appropriate care is to be offered, which can serve complex needs covering the remaining life of patients, as well as the bereavement of their families (Teike Lüthi et al 2020). Various methods exist to identify PC needs.…”

“…Various methods exist to identify PC needs. These can include setting-based calculations across health-care settings (Fumaneeshoat 2018;Schoenherr et al 2019), direct measurement (Amblàs-Novellas et al 2016;G ó mez-Batiste et al 2014G ó mez-Batiste et al , 2012Teike Lüthi et al 2020), and estimation (Daya et al 2017;Murtagh et al 2014; 2 Nithra Kitreerawutiwong et al Swarbrick et al 2019). PC needs must be reported in the form of prevalence based on the concept of public health-oriented PC.…”