Adaptation of the Quality of Communication Questionnaire for Family Members and Its Validity Evidence for Use in Brazil

Abstract

Assessment of communication between physicians and patients’ family members is essential to improving healthcare quality. To adapt the Quality of Communication Questionnaire (QoC) for family members and to analyze its validity evidence for use in Brazil. Data were collected between 2017 and 2019, with family members of patients in intensive care (IC) and palliative care (PC) from five public hospitals in the South Brazil. The QoC was adapted for family members for use in Brazil, and its cross-cultural adaptation was carried out. The clarity and cultural appropriateness of the pre-final version were evaluated by 30 family members of patients in IC. The final version was responded by 198 family members of patients. All items were considered clear, and appropriate to Brazilian culture. The goodness of fit index for proposed model had CFI 0.96 (CI95%: 0.94 – 0.98), TLI 0.95 (CI95%: 0.92 – 0.97), RMSEA 0.07 (CI90%: 0.06 – 0.08), and χ²/df 2.18. Cronbach’s alpha coefficient (α) among family members of patients in PC was 0.88 for the general communication (first subscale) and 0.80 for the end-of-life communication (second subscale). However, among family members of patients in IC, α was 0.86 for the first subscale and only 0.53 for the second subscale. The QoC for family members and its cross-cultural adaptation were carried out successfully. It has strong validity evidence among those with loved ones in PC, but only the QoC general communication subscale has strong validity evidence among those with loved ones in IC.

Keywords

communication family critical care intensive care palliative care

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References

Maguire

Carson

. Strategies to combat chronic critical illness. Curr Opin Crit Care. 2013;19(5):480-487. doi:10.1097/MCC.0b013e328364d65e

Cox

Jones

Reagan

, et al. Palliative care planner: A pilot study to evaluate acceptability and usability of an electronic health records system-integrated, needs-targeted app platform. Ann Am Thorac Soc. 2018;15(1):59-68. doi:10.1513/AnnalsATS.201706-500OC

Imanipour

Kiwanuka

Akhavan Rad

Masaba

Alemayehu

. Family members’ experiences in adult intensive care units: A systematic review. Scand J Caring Sci. 2019;33(3):569-581. doi:10.1111/scs.12675

Friedman

Collin

Martin

. Staff perceptions of challenging parent-staff interactions and beneficial strategies in the neonatal intensive care unit. Acta Paediatr. 2018;107(1):33-39. doi:10.1111/apa.14025

Azoulay

Pochard

Kentish-Barnes

, et al. Risk of post-traumatic stress symptoms in family members of intensive care unit patients. Am J Respir Crit Care Med. 2005;171(9):987-994. doi:10.1164/rccm.200409-1295OC

Hanson

Zimmerman

Song

M-K

, et al. Effect of the goals of care intervention for advanced dementia. JAMA Intern Med. 2017;177(1):24-31. doi:10.1001/jamainternmed.2016.7031

Newcomb

Allred

Grove

, et al. Surgeon communication and family understanding of patient prognosis in critically ill surgical patients: A qualitative investigation informs resident training. J Surg Educ. 2019;76(6):e77-e91. doi:10.1016/j.jsurg.2019.05.017

Torke

Monahan

Callahan

, et al. Validation of the family inpatient communication survey. J Pain Symptom Manag. 2017;53(1):96-108. doi:10.1016/j.jpainsymman.2016.08.010

Bute

Petronio

Torke

. Surrogate decision makers and proxy ownership: Challenges of privacy management in health care decision making. Health Commun. 2015;30(8):799-809. doi:10.1080/10410236.2014.900528

10.

Davidson

Aslakson

Long

, et al. Guidelines for family-centered care in the neonatal, pediatric, and adult ICU. Crit Care Med. 2017;45(1):103-128. doi:10.1097/CCM.0000000000002169

11.

Trees

Ohs

Murray

. Family communication about end-of-life decisions and the enactment of the decision-maker role. Behav Sci. 2017;7(2):36. doi:10.3390/bs7020036

12.

Hickman

Jr Daly

Lee

. Decisional conflict and regret: Consequences of surrogate decision making for the chronically critically ill. Appl Nurs Res. 2012;25(4):271-275. doi:10.1016/j.apnr.2011.03.003

13.

Zante

Camenisch

Schefold

. Interventions in post-intensive care syndrome-family: A systematic literature review. Crit Care Med. 2020;48(9):e835-e840. doi:10.1097/CCM.0000000000004450

14.

Lewis

Taylor

. Impact of prior ICU experience on ICU patient family members’ psychological distress: A descriptive study. Intensive Crit Care Nurs. 2017;43:129-135. doi:10.1016/j.iccn.2017.09.008

15.

Fumis

RRL

Ranzani

Martins

Schettino

. Emotional disorders in pairs of patients and their family members during and after ICU stay. PLoS One. 2015;10(1):e0115332. doi:10.1371/journal.pone.0115332

16.

Wessman

Sona

Schallom

. Improving caregivers’ perceptions regarding patient goals of care/end-of-life issues for the multidisciplinary critical care team. J Intensive Care Med. 2017;32(1):68-76. doi:10.1177/0885066615606063

17.

Higginson

Koffman

Hopkins

, et al. Development and evaluation of the feasibility and effects on staff, patients, and families of a new tool, the Psychosocial Assessment and Communication Evaluation (PACE), to improve communication and palliative care in intensive care and during clinical uncertainty. BMC Med. 2013;11:213. doi:10.1186/1741-7015-11-213

18.

Engelberg

Downey

Curtis

. Psychometric characteristics of a quality of communication questionnaire assessing communication about end-of-life care. J Palliat Med. 2006;9(5):1086-1098. doi:10.1089/jpm.2006.9.1086

19.

Chen

Meier

. Selecting the best instrument to measure family perceptions of end-of-life communication in intensive care units. Am J Hospice Palliat Med. 2020;37(2):154-160. doi:10.1177/1049909119867623

20.

Castanhel

Grosseman

. Quality of Communication Questionnaire for COPD patients receiving palliative care: Translation and cross-cultural adaptation for use in Brazil. J Bras Pneumol. 2017;43(5):357-362. doi:10.1590/S1806-37562016000000199

21.

Castanhel

Burg

Nogueira

de Oliveira Filho

Grosseman

. Quality of communication questionnaire for patients hospitalized in intensive and palliative care unit: Validity evidence for use in Brazil. Am J Hosp Palliat Care. 2021;39(5):535-541. doi:10.1177/10499091211047647

22.

Beaton

Bombardier

Guillemin

Ferraz

. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine. 2000;25(24):3186-3191. doi:10.1097/00007632-200012150-00014

23.

Mokkink

Prinsen

CAC

Bouter

Vet

HCWd.

Terwee

. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) and how to select an outcome measurement instrument. Braz J Phys Ther. 2016;20(2):105-113. doi:10.1590/bjpt-rbf.2014.0143

24.

Hair

Black

Babin

Anderson

. Multivariate Data Analysis. 7th ed. Upper Saddle River: Pearson Education; 2010.

25.

Curtis

Patrick

. Barriers to communication about end-of-life care in AIDS patients. J Gen Intern Med. 1997;12(12):736-741. doi:10.1046/j.1525-1497.1997.07158.x

26.

Curtisa

Patrick

Caldwell

Greenlee

Collier

. The quality of patient-doctor communication about end-of-life care: a study of patients with advanced AIDS and their primary care clinicians. AIDS. 1999;13(9):1123-1131. doi:10.1097/00002030-199906180-00017

27.

Curtis

Wenrich

Carline

Shannon

Ambrozy

Ramsey

. Patients’ perspectives on physician skill in end-of-life care. Chest. 2002;122(1):356-362. doi:10.1378/chest.122.1.356

28.

Wenrich

Curtis

Shannon

Carline

Ambrozy

Ramsey

. Communicating with dying patients within the spectrum of medical care from terminal diagnosis to death. Arch Intern Med. 2001;161(6):868-874. doi:10.1001/archinte.161.6.868

29.

Curtis

Wenrich

Carline

Shannon

Ambrozy

Ramsey

. Understanding physicians’ skills at providing end-of-life care. J Gen Intern Med. 2001;16(1):41-49. doi:10.1111/j.1525-1497.2001.00333.x

30.

Wenrich

Curtis

Ambrozy

Carline

Shannon

Ramsey

. Dying patients’ need for emotional support and personalized care from physicians. J Pain Symptom Manag. 2003;25(3):236-246. doi:10.1016/s0885-3924(02)00694-2

31.

Lynn

. Determination and quantification of content validity. Nurs Res. 1986;35(6):382-386.

32.

Kline

. Principles and Practice of Structural Equation Modeling. 4th ed. NY: The Guilford Press; 2011.

33.

Balaban

. A physician’s guide to talking about end-of-life care. J Gen Intern Med. 2000;15(3):195-200.

34.

Song

M-K

Van Riper

Yoo

Y-S

Knafl

Beeber

. Translation and cultural adaptation of the quality of communication questionnaire for ICU family members in Korea. Heart Lung. 2017;46(6):458-463. doi:10.1016/j.hrtlng.2017.08.002

35.

Smith-Howell

Hickman

Meghani

Perkins

Rawl

. End-of-life decision making and communication of bereaved family members of African Americans with serious illness. J Palliat Med. 2016;19(2):174-182. doi:10.1089/jpm.2015.0314

36.

Werbrouck

Swinnen

Kerckhofs

Buyl

Beckwée

De Wit

. How to empower patients? A systematic review and meta-analysis. Translational Behavioral Medicine. 2018;8(5):660-674. doi:10.1093/tbm/iby064

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