Adaptation and psychometric testing of the end-of-life professional caregiver survey in Jamaica

Rebecca L Edwards; Marie Bakitas; Peng Li; Dingle Spence; Eulalia Kahwa; Mark Stoltenberg; Nataliya V Ivankova; Kaesha Thomas; Kammar Segree; Syed Matthew Kodilinye; Adelais Markaki

doi:10.1186/s12913-023-09497-2

Adaptation and psychometric testing of the end-of-life professional caregiver survey in Jamaica

BMC Health Serv Res. 2023 May 16;23(1):498. doi: 10.1186/s12913-023-09497-2.

Authors

Rebecca L Edwards¹, Marie Bakitas², Peng Li³, Dingle Spence^{4

5

6}, Eulalia Kahwa⁷, Mark Stoltenberg^{8

9}, Nataliya V Ivankova¹⁰, Kaesha Thomas⁶, Kammar Segree⁶, Syed Matthew Kodilinye⁶, Adelais Markaki¹¹

Affiliations

¹ Department of Acute, Chronic, and Continuing Care, School of Nursing, University of Alabama at Birmingham, 1720 2nd Avenue South, Birmingham, AL, 35294-1210, US. rledwards@uab.edu.
² School of Nursing, University of Alabama at Birmingham, Birmingham, AL, US.
³ Department of Acute, Chronic, and Continuing Care, School of Nursing, University of Alabama at Birmingham, 1720 2nd Avenue South, Birmingham, AL, 35294-1210, US.
⁴ Hope Institute Hospital, 7 Golding Ave, Kingston 7, Mona, Jamaica.
⁵ Department of Medicine, University of the West Indies, Mona Campus, Mona, Jamaica.
⁶ Jamaica Cancer Care and Research Institute, University of the West Indies, Mona Campus, Mona, Jamaica.
⁷ School of Health and Behavioral Sciences, University of the West Indies, Five Islands Campus, Antigua and Barbuda, Jamaica.
⁸ Global Palliative Care Program, Division of Palliative Care and Geriatrics, Massachusetts General Hospital, Boston, Massachusetts, US.
⁹ Harvard Medical School, Boston, Massachusetts, US.
¹⁰ Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, US.
¹¹ PAHO/WHOCC for International Nursing, Family, Community and Health Systems Department, School of Nursing, University of Alabama at Birmingham, Birmingham, AL, US.

Abstract

Background: Using a validated instrument to measure palliative care (PC) educational needs of health professionals is an important step in understanding how best to educate a well-versed PC workforce within a national health system. The End-of-life Professional Caregiver Survey (EPCS) was developed to measure U.S. interprofessional PC educational needs and has been validated for use in Brazil and China. As part of a larger research project, this study aimed to culturally adapt and psychometrically test the EPCS among physicians, nurses, and social workers practicing in Jamaica.

Methods: Face validation involved expert review of the EPCS with recommendations for linguistic item modifications. Content validation was carried out by six Jamaica-based experts who completed a formal content validity index (CVI) for each EPCS item to ascertain relevancy. Health professionals practicing in Jamaica (n = 180) were recruited using convenience and snowball sampling to complete the updated 25-item EPCS (EPCS-J). Internal consistency reliability was assessed using Cronbach's [Formula: see text] coefficient and McDonald's [Formula: see text]. Construct validity was examined through confirmatory factor analysis (CFA) and exploratory factor analysis (EFA).

Results: Content validation led to elimination of three EPCS items based on a CVI < 0.78. Cronbach's [Formula: see text] ranged from 0.83 to 0.91 and McDonald's [Formula: see text] ranged from 0.73 to 0.85 across EPCS-J subscales indicating good internal consistency reliability. The corrected item-total correlation for each EPCS-J item was > 0.30 suggesting good reliability. The CFA demonstrated a three-factor model with acceptable fit indices (RMSEA = 0.08, CFI = 0.88, SRMR = 0.06). The EFA determined a three-factor model had the best model fit, with four items moved into the effective patient care subscale from the other two EPCS-J subscales based on factor loading.

Conclusions: The psychometric properties of the EPCS-J resulted in acceptable levels of reliability and validity indicating that this instrument is suitable for use in measuring interprofessional PC educational needs in Jamaica.

Keywords: Education; End-of-life; Hospice; Interprofessional; Low- and middle-income countries; Palliative care; Psychometrics; Validity.

MeSH terms

Caregivers*
Humans
Jamaica
Psychometrics / methods
Reproducibility of Results
Surveys and Questionnaires

Grants and funding

134328-DSCN-20-077-01-SCN/American Cancer Society