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Measuring relatives’ perspectives on the quality of palliative care: the Consumer Quality Index Palliative Care.

Claessen, S.J.J., Francke, A.L., Sixma, H.J., Veer, A.J.E. de, Deliens, L. Measuring relatives’ perspectives on the quality of palliative care: the Consumer Quality Index Palliative Care. Journal of Pain and Symptom Management: 2013, 45(5), 875-884
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Context: A Consumer Quality Index (CQ-index) is a questionnaire assessing the actual care experiences and how important the recipient finds certain care aspects, as well as the priorities for improving quality. A CQ-index Palliative Care (CQ-index PC) for bereaved relatives was developed to measure the quality of palliative care. Objectives: This article provides insight into the development and psychometric characteristics of this questionnaire, as well as quality improvement priorities. Methods: The content of the CQ-index PC was based on existing questionnaires, literature, and interviews and focus group discussions with relatives, patients, and caregivers. The questionnaire was tested in 31 care facilities providing palliative care. Close relatives/contact persons of patients who died non-suddenly six weeks to six months earlier were eligible for inclusion. Psychometric analyses were performed to shorten the questionnaire and to assess its reliability. “Need for improvement scores” also were computed to identify care aspects with the highest priority for quality improvement. Results: Three hundred ninety-two bereaved relatives were eligible for inclusion. The net response was 52% (n=204). Psychometric analyses resulted in six scales (Cronbach's alphas ranging from 0.71 to 0.90). The quality aspects relatives considered most important were dying peacefully, getting help in good time in acute situations, and personal attention. Aftercare was the aspect with the highest priority for quality improvement. Conclusion: The CQ-index PC for relatives can be used to assess the quality of palliative care from the perspective of bereaved relatives. This instrument gives health care professionals insight into care aspects with the highest priority for quality improvement. (aut. ref.)