The Development of Instrument to Assess Physician’s Practice in the Management of Patients With Terminal Diseases

Abstract

Background The need for improving knowledge and practice of palliative care delivered by health workers become an agenda in several countries. In order to measure the practice, an instrument is needed. The study analyzed the validity and reliability of the instrument to assess the physician’s practice in the management of patients with terminal diseases. Methods This was a cross-sectional study involving 89 physicians practicing in primary health care. The instrument of practice has been developed and resulted 5 domains consist of 20 items. An overview of reliability, construct validity, uni-dimensionality, and hierarchy of the person-items of the instrument were analyzed using Rasch Model. Results The reliability of the instrument is excellent with a person measure reliability of 0.85 and the item measure reliability of 0.96. Construct validity is confirmed with the MNSQ outfit values in the range of 0.54 to 1.59 and Pt Measure Corr. values in the range of 0.31 to 0.8. This instrument has a value of more than 20% unidimensionality which indicates the level of independence for items is good. Conclusion The instrument has good validity and reliability to assess physician’s practice in the management of patients with terminal disease.

Psychometric validation of the Cognitive Abilities Screening Instrument using Rasch analysis in people with dementia

“…The person-item map provided information regarding how well the items are distributed with regard to the ability of the respondent. [24,25] Targeting results of 0.22 logits shows that the CASI 46 items had good targeting to the responders. In addition, The CASI assessed all participants similarly, independently gender.…”

“…An item with an infit or outfit mean square < 0.5 or > 1.5 demonstrated a misfit. [24,25] We deleted the misfit item and then reconducted the Rasch analysis to ensure unidimensionality. Principal component analysis (PCA) on residuals was applied to further ascertain the unidimensionality.…”