title: A measure of palliative care in nursing homes.
abstract: BACKGROUND
  Efforts to improve care for nursing home residents stand to be enhanced by measures to assess the degree to which staff provide palliative care. As the incidence of death in nursing homes increases with the aging population, the gap in measurement must be addressed. To that end, we report the development and psychometric testing of a nursing home palliative care survey.
  
  
  OBJECTIVE
  The purpose of this study was to evaluate the psychometric properties of the Palliative Care Survey (PCS) for use in nursing homes.
  
  
  METHODS
  Psychometric evaluation of the instrument was completed in two phases. Phase 1 focused on individual item analyses and subsequent revision or deletion of items, and Phase 2 evaluated evidence for reliability and validity. Phase 1 included 26 nursing homes and staff (n=717), and Phase 2 included 85 nursing homes and staff (n=2779). Data were analyzed using item-total correlations, Cronbach's alpha, confirmatory factor analysis, and analysis of variance.
  
  
  RESULTS
  Support was obtained for a 51-item PCS made up of two constructs, Palliative Care Practice and Palliative Care Knowledge.
  
  
  CONCLUSIONS
  The PCS measures the extent to which the nursing home staff engage in palliative care practices and have knowledge consistent with good end-of-life care. Both practice and knowledge are an essential foundation to providing good end-of-life care to nursing home residents. Efforts to improve care for the dying in nursing homes have been slowed by an absence of measurement tools that capture care processes, a gap that the PCS reported here helps fill.
authors.affiliation: University of Nebraska Medical Center College of Nursing, Omaha, Nebraska, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Thompson
authors.affiliation: University of Kansas School of Nursing, Kansas City, Kansas, USA.
authors.forename: Marjorie
authors.initials: M
authors.lastname: Bott
authors.affiliation: University of Kansas School of Nursing, Kansas City, Kansas, USA.
authors.forename: Diane
authors.initials: D
authors.lastname: Boyle
authors.affiliation: University of Kansas School of Nursing, Kansas City, Kansas, USA; School of Medicine, Kansas City, Kansas, USA.
authors.forename: Byron
authors.initials: B
authors.lastname: Gajewski
authors.affiliation: University of Nebraska Medical Center College of Nursing, Omaha, Nebraska, USA.
authors.forename: Virginia P
authors.initials: VP
authors.lastname: Tilden
mesh_terms: D000328:Adult; D000368:Aged; D002983:Clinical Competence / Q000706:statistics & numerical data; D004650:Employee Performance Appraisal / Q000379:methods / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D009735:Nursing Homes / Q000706:statistics & numerical data*; D009740:Nursing Staff / Q000145:classification / Q000706:statistics & numerical data*; D010166:Palliative Care / Q000706:statistics & numerical data*; D011594:Psychometrics / Q000379:methods*; D011785:Quality Assurance, Health Care / Q000379:methods; D014481:United States; D055815:Young Adult
references.citation: Hosp J. 1998;13(1-2):49-60
references.pmid: 9644392
references.citation: J Palliat Med. 2005 Apr;8(2):273-9
references.pmid: 15890038
references.citation: J Am Geriatr Soc. 2007 Sep;55(9):1371-9
references.pmid: 17915342
references.citation: Health Soc Work. 2001 Feb;26(1):38-48
references.pmid: 11338278
references.citation: Alzheimer Dis Assoc Disord. 2006 Jul-Sep;20(3):176-81
references.pmid: 16917188
references.citation: Geriatr Nurs. 2005 Jul-Aug;26(4):259-64
references.pmid: 16109300
references.citation: Health Care Manage Rev. 2007 Oct-Dec;32(4):341-51
references.pmid: 18075443
references.citation: Gerontologist. 2002 Oct;42 Spec No 3:11-9
references.pmid: 12415128
references.citation: Med Care. 1991 Aug;29(8):709-26
references.pmid: 1875739
references.citation: Int J Palliat Nurs. 2008 Jan;14(1):38-44
references.pmid: 18414331
references.citation: Health Qual Life Outcomes. 2009 Jan 23;7:3
references.pmid: 19166601
references.citation: Gerontologist. 2003 Apr;43 Spec No 2:76-84
references.pmid: 12711727
references.citation: J Nurs Scholarsh. 2000;32(3):251-8
references.pmid: 12462819
references.citation: J Gerontol Nurs. 2001 Nov;27(11):37-45
references.pmid: 11820356
references.citation: J Palliat Med. 2005 Jun;8(3):545-55
references.pmid: 15992196
references.citation: J Palliat Med. 2008 Jul;11(6):866-77
references.pmid: 18715179
references.citation: J Nurs Care Qual. 2004 Jul-Sep;19(3):242-52
references.pmid: 15326994
references.citation: J Am Med Dir Assoc. 2004 May-Jun;5(3):147-55
references.pmid: 15115574
references.citation: JAMA. 2006 Feb 8;295(6):681-6
references.pmid: 16467237
references.citation: J Nurs Care Qual. 2005 Jan-Mar;20(1):36-42
references.pmid: 15686075
references.citation: Med Care. 1994 May;32(5):508-25
references.pmid: 8182978
references.citation: J Pain Symptom Manage. 2009 Sep;38(3):440-51
references.pmid: 19735904
references.citation: West J Nurs Res. 2006 Dec;28(8):935-54
references.pmid: 17099106
references.citation: J Am Geriatr Soc. 2008 Jan;56(1):91-8
references.pmid: 17727647
references.citation: J Palliat Med. 2008 Mar;11(2):217-25
references.pmid: 18333736
references.citation: Res Soc Work Pract. 2004 May;14(3):191-200
references.pmid: 21709820