Article

Reliability and Validity of a Tool to Assess Oncology Nurses' Experiences With Prognosis-Related Communication

Amy R. Newman

Paul R. Helft

prognosis, nurses' experiences, disclosure, communication
ONF 2015, 42(1), 64-73. DOI: 10.1188/15.ONF.64-73

Purpose/Objectives: To establish the reliability and validity of a previously developed survey measuring nurses' experiences with prognosis-related communication.

Design: Psychometric testing of survey.

Setting: Mailed survey of Oncology Nursing Society (ONS) members.

Sample: 392 ONS members.

Methods: Reliability was analyzed using Cronbach's alpha. Total scale and subscale characteristics were evaluated through inter-item correlation matrices, average inter-item correlations, corrected item-to-total correlations, and Cronbach's alpha coefficients if the items were removed. Construct validity was assessed using exploratory factor analysis and contrasted group comparisons.

Main Research Variables: Measures of attitudes toward prognosis-related communication, demographic variables.

Findings: A three-factor structure emerged with acceptable reliability and validity. Contrasted group comparisons revealed differences in prognosis-related communication by nurses' years of experience with patients with cancer, level of education, and extent of education about prognosis-related communication.

Conclusions: The final three-factor instrument, Prognosis-Related Communication in Oncology Nursing, was found to have acceptable reliability and validity.

Implications for Nursing: The final instrument can serve as a tool to measure nurses' experiences with prognosis-related communication. Such measurements may guide interventions that aim to improve the process of prognostic disclosure and elucidate the role of the nurse in the process.

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    References

    Cattell, R. B. (1966). The scree test for the number of factors. Multivariate Behavioral Research, 1, 245-276.
    Clayton, J. M., Hancock, K. M., Butow, P. N., Tattersall, M. H., Currow, D. C., Adler, J., … Yates, P. (2007). Clinical practice guidelines for communicating prognosis and end-of-life issues with adults in the advanced stages of a life-limiting illness, and their caregivers. Medical Journal of Australia, 186, S83-S108.
    Clayton, J. M., Hancock, K., Parker, S., Butow, P. N., Walder, S., Carrick, S., … Tattersall, M. H. (2008). Sustaining hope when communicating with terminally ill patients and their families: A systematic review. Psycho-Oncology, 17, 641-659. doi:10.1002/pon.1288
    Comfrey, A. L., & Lee, H. B. (1992). A first course in factor analysis (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum.
    DeVellis, R. F. (2003). Scale development: Theory and applications (2nd ed.). Thousand Oaks, CA: Sage.
    DeVon, H. A., Block, M. E., Moyle-Wright, P., Ernst, D. M., Hayden, S. J., Lazzara, D. J., … Kostas-Polston, E. (2007). A psychometric toolbox for testing validity and reliability. Journal of Nursing Scholarship, 39, 155-164. doi:10.1111/j.1547-5069.2007.00161.x
    Dewar, A. (2000). Nurses' experiences in giving bad news to patients with spinal cord injuries. Journal of Neuroscience Nursing, 32, 324-330.
    Dunniece, U., & Slevin, E. (2000). Nurses' experiences of being present with a patient receiving a diagnosis of cancer. Journal of Advanced Nursing, 32, 611-618.
    Hagerty, R. G., Butow, P. N., Ellis, P. M., Dimitry, S., & Tattersall, M. H. (2005). Communicating prognosis in cancer care: A systematic review of the literature. Annals of Oncology, 16, 1005-1053. doi:10.1093/annonc/mdi211
    Hagerty, R. G., Butow, P. N., Ellis, P. A., Lobb, E. A., Pendlebury, S. C., Leighl, N., … Tattersall, M. H. (2005). Communicating with realism and hope: Incurable cancer patients' views on the disclosure of prognosis. Journal of Clinical Oncology, 23, 1278-1288. doi: 10.1200/JCO.2005.11.138
    Hancock, K., Clayton, J. M., Parker, S. M., Wal der, S., Butow, P. N., Carrick, S., … Tattersall, M. H. (2007). Truth-telling in discussing prognosis in advanced life-limiting illnesses: A systematic review. Palliative Medicine, 21, 507-517. doi:10.1177/0269216307080823
    Helft, P. R., Chamness, A., Terry, C., & Uhrich, M. (2011). Oncology nurses' attitudes toward prognosis-related communication: A pilot mailed survey of Oncology Nursing Society members. Oncology Nursing Forum, 38, 468-474. doi:10.1188/11.ONF.468-474.
    Innes, S., & Payne, S. (2009). Advanced cancer patients' prognostic information preferences: A review. Palliative Medicine, 23, 29-39. doi:10.1177/0269216308098799
    Kaiser, H. F., & Norman, W. T. (1991). Coefficient alpha for components. Psychological Reports, 69, 111-114.
    Kaplowitz, S. A., Campo, S., & Chiu, W. T. (2002). Cancer patients' desires for communication of prognosis information. Health Communication, 14, 221-241. doi:10.1207/S15327027HC1402_4
    Kiely, B. E., Stockler, M. R., & Tattersall, M. H. (2011). Thinking and talking about life expectancy in incurable cancer. Seminars in Oncology, 38, 380-385. doi:10.1053/j.seminoncol.2011.03.007
    Lamont, E. B., & Christakis, N. A. (2003). Complexities in prognostication in advanced cancer: "To help them live their lives the way they want to." JAMA, 290, 98-104. doi:10.1001/jama.290.1.98
    Mack, J. W., Wolfe, J., Grier, H. E., Cleary, P. D., & Weeks, J. C. (2006). Communication about prognosis between parents and physicians of children with cancer: Parent preferences and the impact of prognostic information. Journal of Clinical Oncology, 24, 5265-5270. doi:10.1200/JCO.2006.06.5326
    McLennon, S. M., Uhrich, M., Lasiter, S., Chamness, A. R., & Helft, P. R. (2013). Oncology nurses' narratives about ethical dilemmas and prognosis-related communication in advanced cancer patients. Cancer Nursing, 36, 114-121. doi:10.1097/NCC.0b013e31825f4dc8
    Neuman, B. M., & Fawcett, J. (2002). The Neuman systems model (5th ed.) Upper Saddle River, NJ: Pearson.
    Polit, D. F. (2009). Statistics and data analysis for nursing research (2nd ed.). Upper Saddle River, NJ: Prentice Hall
    Rassin, M., Levy, O., Schwartz, T., & Silner, D. (2006). Caregivers' role in breaking bad news: Patients, doctors, and nurses' points of view. Cancer Nursing, 29, 302-308.
    Reinke, L. F., Shannon, S. E., Engelberg, R. A., Young, J. P., & Curtis, J. R. (2010). Supporting hope and prognostic information: Nurses' perspective on their role when patients have life-limiting prognoses. Journal of Pain and Symptom Management, 39, 982-992. doi:10.1016/j.jpainsymman.2009.11.315
    Tabachnick, B. G., & Fidell, L. S. (2000). Using multivariate statistics (4th ed.). Boston, MA: Pearson Allyn and Bacon.
    Tobin, G. A. (2012). Breaking bad news: A phenomenological exploration of Irish nurses' experiences of caring for patients when a cancer diagnosis is given in an acute care facility (part 1). Cancer Nursing, 35, E21-E29. doi:10.1097/NCC.0b013e318241921d
    Warnock, C., Tod, A., Foster, J., & Soreny, C. (2010). Breaking bad news in inpatient clinical settings: Role of the nurse. Journal of Advanced Nursing, 66, 1543-1555. doi:10.1111/j.1365-2648.2010.05325.x