Good palliative nursing care: Design and validation of the Palliative Nursing Care Quality Scale (PNCQS)

Abstract

El estudio busca desarrollar y evaluar psicométricamente la escala de Calidad del Cuidado Enfermero Paliativo (CCEP). En el estudio 1 participaron 10 informantes clave. En el estudio 2 se obtuvo una muestra de 103 de profesionales de enfermería y en el estudio 3 participaron 176 enfermeras/os de los recursos de cuidados paliativos en España. La escala muestra muy buenas propiedades psicométricas, constatándose una elevada consistencia interna y evidencias de validez interna y convergente. La propuesta de un buen instrumento que delimite el buen cuidado enfermero en los distintos ámbitos de cuidados paliativos, además de establecer indicadores de calidad que guían la práctica enfermera, implica un reconocimiento a la autonomía en el cuidado y supone la oferta de una herramienta de trabajo para sistematizar la evaluación de los cuidados enfermeros en un proceso abierto y de mejora continua.

Aims: Develop and psychometrically assess the Palliative Nursing Care Quality Scale (PNCQS, escala de Calidad del Cuidado Enfermero Paliativo, CCEP, in Spanish). An interview-based qualitative study (1) was conducted to verify construct validity evidence, with psychometric properties of reliability and validity verified by two quantitative studies (2 and 3). Design: Quantitative instrumental, correlational and cross-sectional study. Methods: Study 1 was carried out with 10 key informants. For Study 2, a sample of 103 nursing professionals was obtained, and 176 nurses from palliative care resources in Spain participated in Study 3. Data were collected between May 2017 and May 2018. Results: Evidence of adequate reliability (internal consistency) and validity was found. The confirmatory factor model yielded a single latent factor for the 20 items, with adequate goodness of fit indices. The convergent validity data showed that the highest correlations were with the Dedication subscale of the Utrecht Work Engagement Scale and the Personal Growth subscale of Psychological Well-being, with values of .35 and .34 respectively (p < 0.01 in both cases). Conclusion: The scale shows good psychometric properties, with high internal consistency and evidence of internal and convergent validity. Impact: Proposing a valuable instrument which identifies good nursing in different areas of palliative care while also establishing quality indicators to guide nursing practice entails the recognition of autonomy in care. The resulting work tool can be used to systematize the assessment of nursing care in a process of open and continuous improvement.