Introduction: Chile presents a context of an aging population and increased life expectancy, leading to many older adults (OA) needing palliative care (PC) during the course of their illness. The SPICT-ES™ is an instrument used to clinically evaluate patients with advanced chronic illness (ACI) to detect PC needs. Validating this instrument in Chile will allow for early detection of OA at risk of clinical deterioration who require this care. Objective: Adapt and validate the SPICT-ES™ instrument to identify PC needs among OA in Chile. Methodology: Study following quantitative design – cross-sectional, descriptive, and developed in three stages: cultural adaptation by expert judgment; preliminary test of the SPICT-ESCH instrument to evaluate reliability and application of the SPICT-ESCH in 292 patients, to determine internal consistency and stability of the instrument. This study was done between January 2019 and July 2021. Participants in the study were nurses and OA from 5 health centers in Santiago, Chile. This study was approved by the Ethics Committee of Universidad de los Andes. Results: In the cultural adaptation with content validity, following expert judgment, all items were kept. Semantic modifications were made on only three of them. A Lawshe coefficient of 84% which determined SPICT-ESCH as an acceptable instrument for the following stages of validation and reliability. The pilot for the new version in Chile, SPICT-ESCH, determined stability and consistency over time, with a Pearson correlation coefficient (ρ) of 0.9167 (p < 0.0001). In the final application of the instrument, to fortify the psychometric evaluation (n = 292) we identified 53.4% positive SPICT-ESCH. The logistical model via OR (< 0.001) showed that the items predicted the positivity of the instrument. The internal consistency obtained was 0.8662, confirming a correlation and intercorrelation between items. 100% of nurses evaluated the SPICT-ESCH as a useful and feasible instrument. Conclusion: SPICT-ESCH includes all the relevant indicators for adequate clinical identification of PC needs among the Chilean OA population, who could Benefit from the early introduction of palliative support contributing to their quality of life.
Bibliographical noteFunding Information:
Our thanks to panel of experts: Paula Ossandón, Irene Muñoz, Mauricio Toro, Jorge Barros, Joyce Melnyck, Paula Villagra, Eliana Antuña, Fernando San Cristobal, Juan Rodriguez, Lorena Baez and Antonieta Ricco. To the clinical nurses of the Instituto Nacional de Geriatría, Clínica de la Universidad de los Andes, and the ACALIS Residencies, especially Kathy Gómez, Patricia Cepeda and Claudia Caravante. To Nicolás Valdés for his support in the statistical analysis. To each of the older adults who agreed to use their data and their relatives, and to those who reviewed this article.
This study was supported by the Research Assistance Fund of the Universidad de los Andes, Chile.
© 2022, The Author(s).
- Identification tool
- Palliative care
- SPICT-ES Instrument