Development Of Assessment Tool Research Articles

ОБЗОР МЕТОДИЧЕСКИХ ПОДХОДОВ К ОЦЕНКЕ КАЧЕСТВА ВЕДЕНИЯ ЭЛЕКТРОННЫХ МЕДИЦИНСКИХ КАРТ

Transition to electronic medical records (EMR) is one of the basic directions of digital transformation of healthcare. One of the urgent modern problems of EMR management is the quality of data that are accumulated in modern medical information systems. Given the growing role of EMRs as a source of information for medical decision support systems, the introduction of management elements based on primary data, and the development of research in the field of realworld clinical practice data (RWD), there is a growing need for reliable and objective methods to assess the quality of data accumulated in EMRs. In this regard, the development of reliable methods and tools for data quality assessment (DQA) in EMR is an urgent scientific task. Aim. To study and systematize the approaches, methods and criteria of proposed in the scientific literature. Materials and Methods. Reviews and original articles on the subject of EMRs DQA were studied. Sources were identified by systematic search in four electronic bibliographic databases: PubMed, Web of Science, Scopus and RSCI. Results. The paper presents the main approaches and criteria for assessing the quality of EMR data, harmonizes the terms and definitions of DQA, and identifies the key components required to implement an EMRs DQA system. Conclusion. The generic EMRs DQA criteria formulated in the review can be used for further research and development of DQA tools, including by medical information system developers and health care organizers responsible for the digital transformation of the industry. Also, this work will help eliminate confusion about EMR data quality management and provide the guidance needed to develop effective DQA programs.

Общественное здоровье и демографическое развитие Азиатской России

Abstract. Relevance. In the regions of Asian Russia, there are problems and contradictions in the development of the social sphere, differentiation of urban and rural settlements in terms of infrastructure provision and transport accessibility. Achieving social sustainability of the territories of Asian Russia is the most important condition for the long-term crisis-free development of these territories, maintaining national security and ensuring the national interests of the country. Problems of assessing public health, the effectiveness of the health care system, and demographic development are of particular importance and relevance at the present time. The aim and objectives. As a result, the development of methodological tools for assessing public health, the level of health care development, and demographic development in the regions of Asian Russia became the goal of this study.The objectives of the study included a generalization of Russian and foreign practice in assessing public health, as well as the development of tools for multi-criteria assessment of public health and the level of healthcare development in the regions of Russia based on integral indicators of the effectiveness and resource availability of the healthcare system. Materials and methods. In this study, the authors consider public health as an economic category that reflects the expenditures of the country's economic resources allocated to the protection of public health and the effectiveness of the state policy of the state aimed at protecting public health. As the main indicators characterizing public health, the indicators of healthy life expectancy, total fertility rate, infant mortality rate, mortality rate of the working-age population are defined. Results. The results of the public health assessment indicate that 18 regions of Asian Russia, or two thirds, are characterized by a low level of health system performance in terms of healthy lifestyle expectancy, fertility and mortality rates. A low level of resource provision of the healthcare system is observed in half of the territories, or 14 regions of Asian Russia. Conclusion. As recent experience in the fight against COVID-19 has shown, despite the effective work of all medical organizations and the dedicated work of the country’s medical workers, all the problems that have existed for a long time in the development of the infrastructure of both the healthcare system and other sectors of the country’s social sphere have emerged. There is a general understanding that the infrastructural development of any territory of vast Russia must be carried out according to modern standards and requirements, regardless of its geographical location and administrative status.

Development of a Risk Assessment Tool for Venous Thromboembolism among Hospitalized Patients in the ICU.

ICU patients have a high incidence of VTE. The American College of Chest Physicians antithrombotic practice guidelines recommend assessing the risk of VTE in all ICU patients. Although several VTE risk assessment tools exist to evaluate the risk factors among hospitalized patients, there is no validated tool specifically for assessing the risk of VTE in ICU patients. A retrospective corhort study was conducted between June 2018 and October 2022. We obtained data from the electronic medical records of patients with a variety of diagnoses admitted to a mixed ICU. Multivariable logistic regression analysis was used to evaluate the independent risk factors of VTE. Receiver operating characteristic (ROC) curves were used to analyse the predictive accuracy of different tools. A total of 566 patients were included, and VTE occurred in 89 patients (15.7%), 62.9% was asymptomatic VTE. A prediction model (the ICU-VTE prediction model) was derived from the independent risk factors identified using multivariate analysis. The ICU-VTE prediction model included eight independent risk factors: history of VTE (3 points), immobilization ≥4 days (3 points), multiple trauma (3 points), age ≥70 years (2 points), platelet count >250 × 103/μL (2 points), central venous catheterization (1 point), invasive mechanical ventilation (1 point), and respiratory failure or heart failure (1 point). Patients with a score of 0-4 points had a low (1.81%) risk of VTE. Patients were at intermediate risk, scoring 5-6 points, and the overall incidence of VTE in the intermediate-risk category was 17.1% (odds ratio [OR], 11.1; 95% confidence interval [CI], 4.2-29.4). Those with a score ≥7 points had a high (44.1%) risk of VTE (OR, 42.6; 95% CI, 16.4-110.3). The area under the curve (AUC) of the ICU-VTE prediction model was 0.838, and the differences in the AUCs were statistically significant between the ICU-VTE prediction model and the other three tools (ICU-VTE score, Z = 3.723, P < 0.001; Caprini risk assessment model, Z = 6.212, P < 0.001; Padua prediction score, Z = 7.120, P < 0.001). We identified eight independent risk factors for acquired VTE among hospitalized patients in the ICU, deriving a new ICU-VTE risk assessment model. The model aims to predict asymptomatic VTE in ICU patients. The new model has higher predictive accuracy than the current tools. A prospective study is required for external validation of the tool and risk stratification in ICU patients.

A study on the relationship and path between mental health and burnout of Chinese athletes.

This study aims to explore the relationship and influencing pathways between mental health indicators and athlete burnout among Chinese competitive athletes. A cross-sectional study was conducted on 501 elite Chinese athletes from several national and provincial sports teams. Generalized Anxiety Disorder Scale (GAD-7) was used to measure anxiety, Patient Health Questionnaire (PHQ- 9) was used to measure depression, Athlete Psychological Strain Questionnaire (APSQ) was used to measure perceived stress, and Athlete Burnout Questionnaire (ABQ) was used to measure burnout. The results were derived using reliability testing, descriptive statistics, correlation analyses, and structural equation modeling. The following results were obtained: (a) the clinical detection rates of anxiety and depression in this sample were within normal levels, but the detection rate of perceived stress (78.64%) was relatively high; (b) all three mental health indicators were significantly correlated with athlete burnout; (c) in our model, there was a direct path with APSQ directly contributing to 69.95% of the variance in athlete burnout, and two indirect paths with APSQ exerting an indirect effect through depression or/and anxiety accounting for 30.05% of the variance. The findings revealed the psychological characteristics of Chinese competitive athletes and the direct and indirect effects of the APSQ on burnout. Future research should actively promote the international development and application of burnout assessment tools, conduct more comprehensive studies on athlete mental health monitoring, and intensify efforts in athlete education, treatment, and support services, as well as strategies for athlete's coping stress.

Development of a novel primate welfare assessment tool for research macaques.

Primates are important species for biomedical research and ensuring their good welfare is critical for research translatability and ethical responsibility. Systematic animal welfare assessments can support continuous programme improvements and build institutional awareness of areas requiring more attention. A multi-facility, collaborative project aimed to develop and implement a novel primate welfare assessment tool (PWAT) for use with research macaques. PWAT development involved: establishing an internal focus group of primate subject matter experts, identifying animal welfare categories and descriptors based on literature review, developing a preliminary tool, beta-testing the tool to ensure practicality and final consensus on descriptors, finalising the tool in a database with semi-automated data analysis, and delivering the tool to 13 sites across four countries. The tool uses input- and outcome-based measures from six categories: physical, behavioural, training, environmental, procedural, and culture of care. The final tool has 133 descriptors weighted based upon welfare impact, and is split into three forms for ease of use (room level, site level, and personnel interviews). The PWAT was trialled across facilities in March and September 2022 for benchmarking current macaque behavioural management programmes. The tool successfully distinguished strengths and challenges at the facility level and across sites. Following this benchmarking, the tool is being applied semi-annually to assess and monitor progress in behavioural management programmes. The development process of the PWAT demonstrates that evidence-based assessment tools can be developed through collaboration and consensus building, which are important for uptake and applicability, and ultimately for promoting global improvements in research macaque welfare.

Development and Concurrent Validity of the Short-Form CogDrisk Dementia Risk Assessment Tool

Development and Concurrent Validity of the Short-Form CogDrisk Dementia Risk Assessment Tool

Problems and challenges of using randomized automatically evaluating geometric construction problems in Moodle LMS

&lt;abstract&gt;&lt;p&gt;The objective of this paper was to examine the present state of geometric constructions in both international and national mathematics assessments. Additionally, it aimed to shed light on the noticeable lack of geometric construction items in these assessments and propose a solution to incorporate such items by utilizing a web-based mathematics assessment tool. After providing a brief summary of the unique benefits associated with geometric construction problems, the subsequent paper explored the development of a web-based mathematics assessment tool, the procedure for generating automatic evaluation GeoGebra applets for geometric construction problems, and their integration into Moodle learning management system (LMS). The purpose of this assessment tool was to enhance the evaluation of a substantially larger group of students within the realm of geometric constructions. The final section of the paper examined the difficulties encountered in the creation of the automatic evaluation applets and their incorporation into Moodle LMS. Through the development of such a web-based mathematics assessment tool, we enabled the evaluation of a significantly larger number of students, thus aiding not only national and international mathematics examinations but also assisting mathematics teachers in tracking students' scores and progress.&lt;/p&gt;&lt;/abstract&gt;

The development of a risk assessment tool for patients with postoperative pneumonia after gastrectomy for gastric cancer

BackgroundAlthough frail patients are known to experience increased postoperative complications, this is unclear for postoperative pneumonia (POP). We investigated associations between frailty and POP in patients with gastric cancer (GC) undergoing gastrectomy. MethodsIn this prospective study conducted between August 2016 and December 2022, we preoperatively assessed frailty in 341 patients with GC undergoing gastrectomy using a frailty index (FI). Patients were divided into high FI vs low FI groups to examine frailty and pneumonia rates after gastrectomy for GC. ResultsOf 327 patients, 18 (5.5%) experienced POP after gastrectomy. Multivariate analyses showed that a high FI and total or proximal gastrectomy (TG/PG) were independent risk factors for POP (high FI: odds ratio [OR], 5.00; 95% CI, 1.77–15.54; TG/PG: OR, 3.07; 95% CI, 1.09–8.78). The proportion of patients with POP was 2.4% in those with nonhigh FI and non-TG/PG, 5.3% in those with nonhigh FI and TG/PG, 7.1% in those with high FI and non-TG/PG, and 28.0% in those with high FI and TG/PG (P < .001). The area under the receiver operating characteristic curve for this risk assessment for predicting POP was 0.740. ConclusionIn patients with GC undergoing gastrectomy, POP was independently associated with preoperatively high FI and TG/PG. Our simple POP risk assessment method, which combines these factors, may effectively predict and prepare patients for POP.

Assessment of school readiness and the importance of executive functions for learning.

Considering the importance of the beginning of the academic trajectory for children to reach their full development, this work aims to evaluate the school readiness of preschool-age children and identify which factors influence these results, in order to contribute to the proposition of strategies that allow improving the teaching-learning process and child development. This is a cross-sectional, descriptive and analytical study with 443 preschool children belonging to the West Region Cohort (ROC Cohort), from the public school system of the city of São Paulo. School readiness was assessed by the International Development and Early Learning Assessment (IDELA) tool. Non-parametric techniques were used for the correlation analysis between IDELA scores and sociodemographic and socioeconomic conditions: Spearman's parametric correlation, Mann-Whitney and Kruskal-Wallis tests. The children's mean age was 69 months (standard deviation - SD=2.8; ranging from 55 to 72 months) and most of them came from families with low socioeconomic level. Most children showed adequate readiness in the overall score (65%) and in most domains, except for emergent literacy, in which most (56.9%) were classified as "emergent". The highest percentage of insufficiency was identified in executive functions (4.1%), which showed a correlation only with the caregiver's education. Children had adequate school readiness scores, except for emergent literacy, but the insufficiency in executive functions may compromise the future schooling of these children. Thus, pedagogical proposals should consider these aspects for learning and pediatricians need to reinforce the habit of reading and playing games to stimulate child development.

Predictors of change in early child development among children with stunting: Secondary analysis of a randomized trial in Uganda.

Millions of children under 5 years in low- and middle-income countries fail to attain their development potential with accruing short- and long-term consequences. Low length/height for age (stunting) is known to be a key factor, but there is little data on how child characteristics are linked with developmental changes among children with stunting. We assessed the socioeconomic, household, anthropometric, and clinical predictors of change in early child development (ECD) among 1-5-year-old children with stunting. This was a prospective cohort study nested in a randomized trial testing effects of lipid-based nutrient supplementation among children with stunting in Uganda. Development was assessed using the Malawi Development Assessment Tool (MDAT). Multiple linear regression analysis was used to assess for predictors of change. We included 750 children with mean ±SD age of 30.2 ±11.7 months 45% of whom were female. After 12 weeks, total MDAT z-score increased by 0.40 (95%CI: 0.32; 0.48). Moderate vs severe stunting, higher fat-free mass, negative malaria test and no inflammation (serum α-1-acid glycoprotein <1 g/l) at baseline predicted greater increase in ECD scores. Older age and fat mass gain predicted a lesser increase in ECD. Our findings reinforce the link between stunting and development with more severely stunted children having a lesser increase in ECD scores over time. Younger age, freedom from malaria and inflammation, and higher fat-free mass at baseline, as well as less gain of fat mass during follow-up predicted a higher increase in developmental scores in this study. Thus, supporting fat-free mass accretion, focusing on younger children, and infection prevention may improve development among children with stunting.

Повышение мотивации к занятиям физической культурой в школе средствами интегрированного обучения

The article examines the relevance of using an integrated approach in teaching physical education in the fifth grade to increase students’ motivation to engage in physical culture. The problem of reducing the level of health of children of primary and senior school age has been identified, where one of the reasons influencing this indicator is a decrease in the level of motivation to engage in physical culture. The lack of this motivation stems from a misunderstanding of how physical activity affects the body. Undoubtedly, the current work programs on physical culture contain educational material on the disclosure of the topic of the effect of exercise on the body, but this is not always enough to stimulate physical education in the present and in the future. To solve the problem, the author suggests using tasks integrated with physical education in academic subjects. The results obtained after the introduction of complex tasks showed that the level of motivation for physical education increased. To assess the level of motivation, the author used the questionnaire of N.G. Luskanova adapted to the physical education subject. Together with an increase in the level of motivation, integrated tasks, according to the author’s hypothesis, were aimed at the formation of universal educational actions; to measure their formation, the author developed assessment tools (a test). The test results showed positive dynamics in the formation of universal learning activities due to the introduction of integrated tasks. Students began to better evaluate the technique of motor actions, as well as to produce a better self-assessment of the performance of their motor actions in sports mastered in physical education classes. At the same time, the author noted a number of positive aspects in changing the students’ attitude to physical education classes: the absence of difficulties for students in mastering physical culture, improving relationships with the teacher, the disappearance of negative attitudes towards the performance of written and practical tasks, which as a result led to the absence of skipping classes for no good reason.

Development and validation of a performance-based palliative care assessment tool for student pharmacists

IntroductionIntegration of hospice and palliative care principles within pharmacy curricula is essential to fill the need of pharmacist training in this growing specialty. A formalized assessment tool to evaluate skill development does not exist for student pharmacists specific to palliative care. The objective of this study was to develop a valid and reliable, palliative care-focused, performance-based assessment tool for student pharmacists. MethodsEight academic palliative care (PC) pharmacists were recruited for the workgroup to perform domain development, validation, tool creation, and reliability testing for this performance-based assessment tool. Hospice and palliative care clinical pharmacist entrustable professional activities (EPAs) served as the framework. Content validity testing utilized content validity index and scale universal agreement (S-CVI/UA) to determine level of agreement for activities included in the tool. Student volunteers completed a standardized patient case and workgroup members served as raters during the reliability testing phase. Interrater reliability was measured through calculation of Fleiss Kappa scores for each activity. ResultsOut of 14 EPAs, nine were deemed “essential” to include in the tool. Thirty-four supporting activities for the nine essential EPAs were drafted. Two rounds of content validity testing were necessary to achieve S-CVI/UA of 0.9593. Consensus was reached from workgroup members for activities deemed necessary to include in the tool after questionnaire distribution utilizing a Fleiss Kappa cutoff >0.6. ConclusionsThis validated tool will afford colleges and schools of pharmacy with PC curricula an opportunity to assess student achievement of PC-specific skills and evaluate curricular effectiveness.

DEVELOPING ASSESSMENT INSTRUMENTS FOR LEARNING OUTCOMES

This paper aims to provide understanding of assessment instruments for learning outcomes, focusing on benchmark learning outcome tools, norm-referenced and benchmark-referenced tests, validity, reliability, and practicality considerations, various types of tests, and the process of preparing assessment tools. Additionally, it explores performance-based assessment tools, emphasizing the significance of authentic assessment in an educational context. The research adopts a qualitative descriptive paradigm, oriented towards understanding nuances, perspectives, and subjective experiences related to learning outcomes assessment tools. This approach allows exploration of perceptions from teachers, students, and other stakeholders. Assessment is a crucial process in education, involving the collection of data to make informed decisions. This paper underscores the importance of various assessment types and techniques, ranging from daily quizzes to school exams. To ensure accurate and meaningful data, educators must use diverse assessment methods aligned with students' learning processes. The development of assessment tools is guided by determining types, forms, and variations based on specific needs. Effective assessment adheres to established principles, ensuring accuracy and reliability. The paper acknowledges potential shortcomings and errors, recommending the creation of a framework, use of relevant sources, effective collaboration, and time management when undertaking similar writing tasks.

Development of Character Assessment Instrument on English Learning FOR Junior High School Students

This research endeavors to address a pressing need in education, specifically, the development of a robust character education assessment tool for junior high school students in the context of English subjects. The primary focus of this study is producing character education assessment instruments in English subjects for junior high school students with good construction. This study is a research and development using the ADDIE development model. The instrument development process consisted of the analysis stage, the design stage, development stage, implementation stage and evaluation stage. The instrument developed is an assessment instrument on English subjects in the form of self-assessment, analyzed using Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). The instrument developed has met the validity and reliability requirements with the results of content validity shown by the Aiken index of 0.955 while the test results with CFA show the loading factor value on each item &gt; 0.4 and the student character measurement model compiled is fit with the theorized model by proving the results of p-values = 0.056; CFI = 0.979; TLI = 0.972; RMSEA = 0.031; SRMR = 0.055 with the results of the reliability of the items in each dimension/factor &gt; 0.7.

Analysis of Descriptive Text Writing Skill Characteristics Based on Performance-Based Assessment for Junior High School Level

This research aims to develop a performance-based assessment model for descriptive text writing skills at the junior high school level. The success of the learning process for descriptive text writing skills in junior high school can be seen in the learning outcomes achieved by students. These learning outcomes are obtained through assessments conducted by teachers at school. However, in reality, teachers face difficulties in developing assessment tools for descriptive text writing skills. These difficulties are addressed by developing a performance-based assessment model for descriptive text writing skills. The research method used in developing the ADDIE model for skills assessment is Research and Development. The ADDIE model consists of five steps: (1) analysis; (2) design for performance-based descriptive text writing; (3) development; (4) implementation; and (5) evaluation. The results of this research include the characteristics of the assessment model for Indonesian language learning at the junior high school level.

Innovative Risk Management: Identification, Assessment and Management of Risks in the Context of Innovative Project Management

"The article aims to solve the critical problem of risk management in the context of innovative projects, which affects the competitiveness and sustainability of organizations in the modern business environment. The purpose of the article is to highlight and develop an innovative approach to risk management in innovative projects to improve their success. The article examines the theoretical foundations of risk management in the context of innovative projects, including concepts, principles, and methods of risk management. The article identifies and analyzes the key risks that arise in the process of implementing innovative projects, including technological, financial, market and organizational risks. The article proposes the development of risk assessment methods and tools in the context of innovative projects, which may include the use of analytical methods, models, and approaches to assess the probability of risk occurrence and their potential impact on projects. The article offers effective methods of risk management in innovative projects the development of proactive measures to prevent risks, the determination of control points, the implementation of backup plans, and the development of a risk monitoring and control system. The article provides practical recommendations and examples of implementing innovative risk management in the real field of innovative project management. The authors examine various aspects of risk management and offer practical recommendations for managing them effectively. The results of the study will contribute to the improvement of risk management practices in organizations engaged in innovative activities and contribute to ensuring sustainable development and competitiveness."

Effect of fatty acid profiles in varying recipes of ready-to-use therapeutic foods on neurodevelopmental and clinical outcomes of children (6-59 months) with severe wasting: a systematic review.

In 2020, 13.6 million children under 5 years suffered from severe acute malnutrition (SAM)/wasting. Standard ready-to-use therapeutic foods (RUTFs) improve polyunsaturated fatty acid (PUFA) status but contain suboptimal amounts of omega-3 (n-3) PUFAs with unbalanced n-6-to-n-3 PUFA ratios. The aim was to compare the effects of RUTFs with different essential fatty acid contents on PUFA status, neurodevelopmental, and clinical outcomes (mortality, comorbidities, and recovery) of children with severe wasting. Twelve databases, trial repositories, and article references with no publication limitations. Ten studies from randomized, quasi, and cluster-randomized controlled trials providing RUTFs as home treatment to children 6-59 months with SAM/wasting were included. Plasma phospholipid eicosapentaenoic acid content was higher in children receiving RUTF with altered essential fatty acid contents compared with standard RUTF (0.20 [0.15-0.25], P < 0.00001). Docosahexaenoic acid (DHA) status only improved in children receiving RUTF with added fish oil (0.33 [0.15-0.50], P = 0.0003). The Malawi Developmental Assessment tool (MDAT) global development and problem-solving assessment scores were higher in global assessment and gross motor domains in children receiving added fish oil compared with standard formulation (0.19 [0.0-0.38] and 0.29 [0.03-0.55], respectively). Children receiving high-oleic-acid RUTF (lowering the n-6:n-3 PUFA ratio of the RUTF) with or without fish oil had significantly higher scores in social domains compared with those receiving the standard formulation (0.16 [0.00-0.31] and 0.24 [0.09-0.40]). Significantly higher mortality risk was found in children receiving a standard formulation compared with RUTF with a lower n-6:n-3 PUFA ratio (0.79 [0.67-0.94], P = 0.008). Although lowering n-6:n-3 PUFA ratios did not increase plasma DHA, it improved specific neurodevelopmental scores and mortality due to lower linoleic acid (high-oleic-acid peanuts), higher alpha-linolenic acid (altered oil), or both. Additional preformed n-3 long-chain PUFAs (fish oil) with RUTF improved the children's DHA status, neurodevelopmental outcomes, and weight-for-height z score. More research is needed regarding cost, availability, stability, acceptability, and the appropriate amount of n-3 long-chain PUFAs required in RUTFs for the best clinical outcomes. PROSPERO registration no. CRD42022303694.

Development of an Acute Pain Assessment Tool for Patients in Post-anesthesia Care Units

BackgroundPost-operative pain is a common form of acute pain. Objective pain assessment in post-anesthesia care units after surgery is useful regardless of the patient's condition. AimsThis study aimed to develop and evaluate an acute pain assessment tool for patients in post-anesthesia care units. DesignThis was a cross-sectional observational study comprising two stages: scale development and psychometric evaluation. Settings . Participants/Subjects . MethodsScale items were developed based on a literature review and content validity by experts. The validity and interrater reliability of the pain scale were evaluated using data from 218 patients admitted to the post-anesthesia care unit at a university hospital. A receiver operating characteristic curve was used to identify the sensitivity and specificity for determining the cutoff point for acute pain. ResultsWe developed an objective acute pain scale, called the APA5, which ranges from 0-10 and comprises behavioral (facial and verbal expressions and body movement) and physiological (changes in heart rate and blood pressure) responses. The APA5 is valid and reliable for assessing acute pain in the recovery room. Sensitivity and specificity were acceptable when the cutoff was 2 out of 10 points. ConclusionsThe APA5 is an easy and simple tool for measuring pain in patients in post-anesthesia care units who have difficulties with self-reporting.

RECOMMENDATIONS REGARDING THE DESIGN OF PAIN ASSESSMENT AND MANAGEMENT TOOL FOR OLDER ADULTS WITH HEART FAILURE

Abstract Nearly 80% of all patients with heart failure (HF) are older adults (≥65 years of age) who are at high risk for frequent hospitalizations. Older adults with HF may delay in responses to pain that could trigger the burden of HF symptoms such as dyspnea due to the increased cardiovascular workload and oxygen demands. However, there is a concern that healthcare providers may be poorly prepared to assess and manage pain when reported by specific populations. This qualitative secondary analysis examined the design recommendations of HF providers for a comprehensive home-based pain assessment and management tool for older adults with HF. The study used in-depth interviews with 20 healthcare providers specializing in HF across different states. Participants provided various recommendations, including a checklist of questions about the patient’s past experience with pain, their living environment, and any activities that trigger pain. While some participants preferred electronic tools, such as an mHealth app, for data collection and analysis, they acknowledged the limitations of using technology for older adults. The tool should be straightforward, easy to navigate, and involve patients in the design process to ensure their motivation and buy-in. The tool should also consider the caregiver’s input. In conclusion, this study highlights the importance of a comprehensive assessment of pain symptoms and daily activities to provide personalized care for older adults with HF. The design recommendations provided by healthcare providers can aid in the development of a unique home-based pain assessment and management tool for older adults with HF.

Development and Validation of the Home Hospice Care Needs Questionnaire for the Dying Old Adult (HHCNQ-DE) in Mainland China.

Context: Home hospice needs assessment is the key to the development of home hospice services. Therefore, there is a need to develop assessment tools in mainland China to meet the comprehensive needs of the old adult at the end of life. Objective: To develop and validate a tool to assess Chinese mainland palliative care needs of the dying old adult at home. Methods: Using the Harmony Nursing Theory as a theoretical framework, through reference to the China home hospice care needs scale, literature research, in-depth conversations with the dying old adult, and group discussions among members of the research team, 43 original questionnaire items were preliminarily drafted. A 31-item predictive questionnaire was formed through 2 rounds of expert review and small sample testing. From April to September 2023, 199 old adult at the end of life at home in Jinzhou, Liaoning Province were investigated to determine the reliability and validity of the questionnaire. Results: The final questionnaire included 31 items. Exploratory factor analysis extracted 5 common factors, and the cumulative variance contribution rate was 68.811%; the Cronbach's alpha coefficient of the total questionnaire was 0.832, and the re-test reliability was .806; the content validity index of the questionnaire was 0.982, and the content validity index of the items was 0.83-1.00. Conclusion: The construction method of the HHCNQ-DE is scientific and reliable, with good reliability and validity, and it can be used as a tool to measure the needs of home hospice care in mainland China in the future.