| Learning Objective #1: Describe a patient satisfaction with comfort management instrument based on King's interacting systems framework | |||
| Learning Objective #2: Analyze three Nursing Outcomes Classifications (NOCs)(Johnson, Maas & Moorhead 2000), pain level, comfort level, and quality of life, for their appropriateness of use as clinical tools in the study population |
Objectives: 1) describe comfort management interventions, 2) test a patient satisfaction with comfort management instrument and three Nursing Outcomes Classifications (NOCs) (Johnson, Maas, & Morehead, 2000) for their appropriateness as clinical tools, and 3) describe out of pocket costs . Design: Methodological design for instrument testing. Longitudinal descriptive design using questionnaires administered in the home setting once a week for three weeks. Population, Sample, Setting, Years: A pre-pilot study with 10 subjects was done in 2000 to estimate the content validity of the Patient Satisfaction with Comfort Management tool (PSCM) (Killeen, 1996). The pilot study recruited 50 patients from Home care/Hospice agencies during 2001. Variables: Charts were audited for comfort management interventions. The outcome variables were: pain level, comfort level, quality of life, patient satisfaction, and costs of comfort care. Methods: Psychometric techniques were used to estimate the reliability and validity of the instruments. Chart data and expense diary information were summarized. Findings. Content validity of the PSCM was a C.V.I. of .95. Test-retest reliability was .74 (p = .004). The Quality of Life outcome measure did not demonstrate criterion related validity. Pain Level (mean 3.11 {SD .77}) , Comfort Level (mean 3.55 {SD .86} and Quality of Life (mean 3.67{SD .84} were at the mid-point or slightly higher on a 5 point Likert scale. Subjects were satisfied with their nursing care (mean 3.07 {SD .90, range 1-4}). Chart data revealed key nursing interventions. Health care costs were captured in several categories. Conclusions: The PSCM needs to be tested with a larger sample. The Quality of Life NOC needs to be reevaluated. The other NOC tools had evidence of reliability and validity and usefulness as data collection tools. Implications. The pilot study results may be used to conduct a quasi-experimental study on the impact of comfort management on patient outcomes.
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