Development and validation of a patient-centered knowledge scale for left ventricular assist device placement
| Autor: | Kristin M. Kostick, Matthias Loebe, Courtenay R. Bruce, Jennifer Blumenthal-Barby, Lidija A. Wilhelms, Mackenzie Abraham, Jerry D. Estep, Estevan D. Delgado, Charles G. Minard, Robert J. Volk |
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| Rok vydání: | 2016 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty medicine.medical_treatment Decision Making 030204 cardiovascular system & hematology Article 03 medical and health sciences 0302 clinical medicine Nursing Cronbach's alpha Health care medicine Humans Ventricular Assist Device Placement 030212 general & internal medicine Heart Failure Transplantation business.industry Reproducibility of Results Cognition Surgery Caregivers Ventricular assist device Scale (social sciences) Structured interview Heart-Assist Devices Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Journal of Heart and Lung Transplantation. 35:768-776 |
| ISSN: | 1053-2498 |
| DOI: | 10.1016/j.healun.2016.01.015 |
| Popis: | Background A central tenet of patient-centered health care advocated by the Institute of Medicine and the American Medical Association is to enhance informed decision-making in a way that incorporates patient values, knowledge and beliefs. Achievement of this goal is constrained by a lack of validated measures of patients' knowledge needs. Methods In this study we present a comprehensive and valid methodology for developing a clinically informed and patientcentered measure of knowledge about left ventricular assist device (LVAD) therapy to facilitate discussion and measure candidate understanding of treatment options. Using structured interviews with patients, caregivers, candidates for LVAD treatment (New York Heart Association Class III and IV) and expert clinicians ( n = 71), we identified top patient decisional needs and perspectives on essential knowledge needs for informed decision-making. From this list, we generated 20 knowledge scale question items to refine in cognitive interviews ( n = 5) with patients and patient consultants. Results Good internal consistency and reliability of the knowledge scale (Cronbach's α = 0.81) was seen in 30 LVAD patients and candidates. Knowledge was higher among patients currently with LVADs than candidates, regardless of receiving standard education (with education: 69.9 vs 50.1, adjusted p = 0.02; without education: 69.9 vs 37.6, adjusted p Conclusion The LVAD knowledge scale may be useful in clinical settings to identify gaps in knowledge among patient candidates considering LVAD treatment, and to better tailor education and discussion with patients and their caregivers, and to enhance informed decision-making before treatment decisions are made. |
| Databáze: | OpenAIRE |
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