Initial Development and Content Validation of the Knowledge of Care Options (KOCO) Instrument (744)

Abstract

1.Describe the purpose of developing and content validating an instrument to measure individual's knowledge of care options.2.List at least three procedures used to content validate the Knowledge of Care Options instrument.3.List three conceptual issues that affected reviewer ratings of items in the Knowledge of Care Options instrument. I. Background. Treatment decision-making may be hindered by lack of knowledge about the care options of curative, palliative, and hospice care. II. Research Objectives. Our purpose was to develop and assess the content validity of an instrument to measure knowledge of care options. III. Methods. We identified three knowledge domains—curative, palliative and hospice care—and generated 22 items based on their common definitions. The 22 items were reduced to 13 by eliminating redundancy and optimizing wording. A content validity rating form was created for use by experts to evaluate items for relevance using a 4-point Likert scale (1=not, 2=somewhat, 3=quite, 4=very), to indicate if items were true or false and to solicit suggestions for each item and for new items. In Round 1 of review, a multidisciplinary panel of 22 experts participated. In Round 2, nine top palliative care experts participated. In each round, we calculated Content Validity Indexes (CVI) for each item (I-CVI) and for the total scale (S-CVI). CVIs of>80% (based on relevancy ratings of 3 or 4) indicate content validity. IV. Results. In Round 1, 11 of 13 items had an I-CVI of>80%. One item was dropped and 3 items were substantially modified. The S-CVI was 89.1%. Experts correctly identified all but one item as true or false. In Round 2, 6 of 12 items had an I-CVI of>80%. One item was dropped due to conceptual ambiguity. Three items (I-CVI 62.5% to 75%) were substantially modified. The S-CVI was 83.3%. Experts correctly indicated all items as true or false. Conceptual issues that affected ratings included potential of cure for advanced and different cancers, and perceptions of palliative versus supportive care. V. Conclusion. The KOCO is content valid. VI. Implications for Research, Policy, or Practice. Cognitive interviewing and feasibility testing is needed to assess the utility of the KOCO for use with patients, family caregivers and healthcare providers.