The HIV quality audit marker (HIV-QAM): an outcome measure for hospitalized AIDS patients.
The development and validation of the HIV-Quality Audit Marker (HIV-QAM), an instrument designed to measure changes in the status of hospitalized AIDS patients due to nursing care, is reported. The HIV-QAM is designed to capture the nurse data-collector's judgment of the status of the patient based upon observations, interviews, record reviews, and listening to inter-shift report. The final version of the 10 item HIV-QAM includes three scales, Self-care (six items; Cronbach's alpha = 0.89), Ambulation (two items, alpha = 0.88), and Psychological Distress (two items, alpha = 0.84). Content validity was supported by selection of items from pre-existing scales, generation of items based on care plans for HIV/AIDS patients, and review and critique of items by a panel of nurse experts. Construct validity was supported by principal components factor analysis and multi-trait scaling analysis. Convergent and divergent concurrent validity with patient symptoms and intensity of nursing care required was demonstrated. The predictive validity of the HIV-QAM for mortality at 3 and 6 months after hospital treatment for Pneumocystis carinii pneumonia was also shown.
Department of Mental Health, Community and Administrative Nursing, School of Nursing, University of California, San Francisco 94143-0604.
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Holzemer
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SB
Henry
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A
Stewart
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Janson-Bjerklie
D000203:Activities of Daily Living; D000328:Adult; D003625:Data Collection; D005069:Evaluation Studies as Topic; D005163:Factor Analysis, Statistical; D005260:Female; D015658:HIV Infections / Q000401:mortality / Q000451:nursing* / Q000503:physiopathology / Q000523:psychology; D006302:Health Services Research / Q000379:methods; D006801:Humans; D008297:Male; D009731:Nursing Audit / Q000379:methods*; D009738:Nursing Service, Hospital / Q000592:standards*; D017063:Outcome Assessment, Health Care / Q000592:standards*; D015203:Reproducibility of Results; D012495:San Francisco; D012648:Self Care; D013315:Stress, Psychological / Q000209:etiology