The Development and Pre-testing of Attitude and Practice Questionnaire on Ethical Decision-making During a Pandemic Among Paediatric Healthcare Professionals in Malaysia

Abstract

Malaysia is facing a widespread COVID-19 pandemic, affecting clinical admission to hospitals. The decision-making for admission, ventilation, and aggressive management for COVID-19 patients, especially children, can be challenging. However, no single tool exists to simultaneously evaluate the domains for attitude and practice on ethical decisions for children during the pandemic. The current study aims to develop and validate an attitude and practice questionnaire on ethical decision-making during a pandemic among medical doctors working in paediatric settings. Relevant domains were identified to generate items and form a research tool through literature reviews, focus groups, and opinions of experts. The questionnaire underwent a series of validation processes, including content, face validity and exploratory factor analysis (EFA). The developed questionnaire demonstrated a satisfactory item-level content validity index, face validity, and construct validity. The minimum item content validity index (I-CVI) of the attitude items was 0.80, and the maximum was 1.00, while the minimum and maximum I-CVI for the practice section were 0.80 and 1.00, respectively. Item-level face validity index (I-FVI) of 1.00 for both domains was obtained, showing all the items were above the cutoff value (0.60). For the EFA, all the items had satisfactory factor loading (>0.3) as well as Cronbach’s alpha (>0.6). This study showed a good level of I-CVI, I-FVI, and EFA in the new questionnaire. The instrument is valid and thus reliable for assessing attitudes and practices on ethical decision-making during a pandemic among medical doctors working in paediatric settings.