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. 2017 Jan;53(1):96-108.e4.
doi: 10.1016/j.jpainsymman.2016.08.010. Epub 2016 Oct 5.

Validation of the Family Inpatient Communication Survey

Alexia M Torke  1 , Patrick Monahan  2 , Christopher M Callahan  3 , Paul R Helft  4 , Greg A Sachs  3 , Lucia D Wocial  5 , James E Slaven  2 , Kianna Montz  6 , Lev Inger  6 , Emily S Burke  6
Affiliations

Validation of the Family Inpatient Communication Survey

Alexia M Torke et al. J Pain Symptom Manage. 2017 Jan.

Abstract

Context: Although many family members who make surrogate decisions report problems with communication, there is no validated instrument to accurately measure surrogate/clinician communication for older adults in the acute hospital setting.

Objectives: The objective of this study was to validate a survey of surrogate-rated communication quality in the hospital that would be useful to clinicians, researchers, and health systems.

Methods: After expert review and cognitive interviewing (n = 10 surrogates), we enrolled 350 surrogates (250 development sample and 100 validation sample) of hospitalized adults aged 65 years and older from three hospitals in one metropolitan area. The communication survey and a measure of decision quality were administered within hospital days 3 and 10. Mental health and satisfaction measures were administered six to eight weeks later.

Results: Factor analysis showed support for both one-factor (Total Communication) and two-factor models (Information and Emotional Support). Item reduction led to a final 30-item scale. For the validation sample, internal reliability (Cronbach's alpha) was 0.96 (total), 0.94 (Information), and 0.90 (Emotional Support). Confirmatory factor analysis fit statistics were adequate (one-factor model, comparative fit index = 0.981, root mean square error of approximation = 0.62, weighted root mean square residual = 1.011; two-factor model comparative fit index = 0.984, root mean square error of approximation = 0.055, weighted root mean square residual = 0.930). Total score and subscales showed significant associations with the Decision Conflict Scale (Pearson correlation -0.43, P < 0.001 for total score). Emotional Support was associated with improved mental health outcomes at six to eight weeks, such as anxiety (-0.19 P < 0.001), and Information was associated with satisfaction with the hospital stay (0.49, P < 0.001).

Conclusion: The survey shows high reliability and validity in measuring communication experiences for hospital surrogates. The scale has promise for measurement of communication quality and is predictive of important outcomes, such as surrogate satisfaction and well-being.

Keywords: Communication; decision making; proxy.

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Figures

Figure 1
Figure 1
Preliminary and Final Conceptual Models
Figure 2
Figure 2
Study Design
Figure 3
Figure 3
Study Enrollment, Development Sample
Figure 4
Figure 4
Study Enrollment, Validation Sample
Figure 5
Figure 5
Total Score Distribution: Family Inpatient Communication Survey
See this image and copyright information in PMC

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References

    1. Torke AM, Sachs GA, Helft PR, et al. Scope and outcomes of surrogate decision making among hospitalized older adults. JAMA Intern Med. 2014 Mar 1;174(3):370–377. - PMC - PubMed
    1. Baker R, Wu AW, Teno JM, et al. Family satisfaction with end-of-life care in seriously ill hospitalized adults. J Am Geriatr Soc. 2000 May;48(5 Suppl):S61–S69. - PubMed
    1. Abbott KH, Sago JG, Breen CM, Abernethy AP, Tulsky JA. Families looking back: one year after discussion of withdrawal or withholding of life-sustaining support.[see comment] Critical Care Medicine. 2001 Jan;29(1):197–201. - PubMed
    1. Breen CM, Abernethy AP, Abbott KH, Tulsky JA. Conflict associated with decisions to limit life-sustaining treatment in intensive care units.[see comment] Journal of General Internal Medicine. 2001 May;16(5):283–289. - PMC - PubMed
    1. Teno JM, Clarridge BR, Casey V, et al. Family perspectives on end-of-life care at the last place of care. JAMA. 2004 Jan 7;291(1):88–93. - PubMed

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