Reliability And Validity Of The Chinese Version Of The Palliative Care Difficulties Scale And Its Application

ObjectivesThe purpose is to introduce and sinicize the palliative care difficulties scale,and to evaluate its reliability and validity,so as to form a measurement tool under the cultural background of China.The scale was used to measure and describe the difficulties faced by medical staff in palliative care practice in oncology department.Methods1.Obtaining the consent of the author,a draft of the Chinese version of the Palliative Care Difficulties Scale was developed by modifying the Brislin classic translation model.2.Reliability and validity test:200 medical staff were investigated.Item analysis was used to evaluate the quality of the Palliative Care Difficulties Scale.Cronbach’s a coefficient,retest reliability were used to test the reliability of the Palliative Care Difficulties Scale and split reliability were used to test the reliability of the Palliative Care Difficulties Scale.Content validity and structure validity were tested.After reliability and validity test,281 medical staff were investigated.Confirmatory factor analysis was used to verify the rationality of the questionnaire structure.3.A cross-sectional survey of 390 Chinese medical oncology staff was conducted.The general situation of 390 medical staff in oncology department was described by frequency and percentage.The score of the Palliative Care Difficulties Scale was expressed as mean±standard deviation.Results1.Exploratory factor analysis showed that the Palliative Care Difficulties Scale contained 4 dimensions and 14 items.Reliability test:Cronbach’s α coeicients of the total amount table and each dimension were 0.974,0.877～0.952,respectively.The retest reliability indexes were 0.861,0.704～0.886,respectively.The fractional reliability is 0.845,0.806～0.945.Validity test:Content validity:I-CVI of each item in this study ranged from 0.90 to 1.00,S-CVI/Ave=0.98;Structural validity:the first exploratory factor analysis of the Palliative Care Difficulties Scale,5 common factors were extracted,and the common factors containing items less than 3 and their items were deleted based on the factor loading results.The second exploratory factor analysis of the Palliative Care Difficulties Scale extracted 4 common factors,retained 14 items of the original scale,and explained 83.837%of the total variation.Model structure:The fitting degree of structural equation model was good,and the results were as follows:x2/df=2.051,RMSER=0.074,RMR=0.047,GFI=0.860,AGFI=0.871.2.The Chinese version of the Palliative Care Difficulties Scale had a score range of（14-70）.Among the 390 subjects,the mean total scale score was（39.87±12.13）.The score of community coordination dimension is the highest,indicating the greatest difficulty.Conclusions1.The Palliative Care Difficulties Scale has good reliability and validity.It is suitable for measuring the difficulties faced by medical staff in the palliative care practice in China.2.Medical staff in the department of oncology face different difficulties in the palliative care practice,such as insufficient coordination between tertiary hospitals and community medical institutions,general difficulties in alleviating symptoms,communication difficulties with patients and family members.Managers should pay attention and implement targeted work programs or workflow to help solve the difficulties faced by oncology medical staff in the palliative care practice.