Development and validation of a reflective tool to measure compassionate care for older people in health and social care settings
Aim: To develop and validate a novel tool to measure compassionate care for older people in health and social care settings. Method: This project utilised a mixed-methods study design, consisting of three phases: 1) a Group Concept Mapping method to define the concept of compassionate care from the perspectives of older people, carers and service providers (n=50); 2) developed a novel tool using the resulting definition to measure compassionate care, pilot test its face and content validity with staff and students (n=20) in health and social care, and amend the tool; 3) assessed the psychometric properties (validity and reliability) of the tool with a sample of staff and students (n=140) in health and care. Results: Participants generated 89 statements describing their understanding of compassionate care, containing eight key themes: non-judgemental, excellent skills which set them apart, above and beyond, genuine are giving, show the person is valued, empathetic, thoughtful and people centred care. These statements were utilised to develop the novel 40-item tool to measure compassionate care. Participants’ feedback was ascertained regarding its face and content validity, and thematic analysis of the data resulted in nine themes regarding necessary amendments to the tool (wording of items, applicability to contexts, format of the tool, ensuring the tool is culturally appropriate, scoring, purpose of the tool, rating question, response options, and instructions). These results informed amendments made prior to a final testing phase. Preliminary statistical analyses of the 40-item reflective tool to measure compassionate care suggested removal of four items. Revised statistical analyses were conducted to assess reliability, which suggest the 36-item tool has acceptable internal consistency (α = 0.934), with item-total correlations >0.3 for all items. Revised statistical analyses for validity suggest that a five-factor model explains at least 40% of the variation in all items (except item 18). All 36 items had factor loadings >.40. These findings indicate that the novel tool has good validity, as the items are measuring the same construct. Qualitative data indicated that further revisions to the content of the tool may be considered. Contributions to new knowledge: This project has produced a novel 36-item reflective tool to measure compassionate care. The findings have contributed to: a novel definition of compassionate care that represents the perspectives of older people, carers and service providers in health and social care settings; a novel reflective tool to measure compassionate care which demonstrates acceptable reliability and validity. Recommendations: Further research is required to confirm the underlying factor structure of the reflective tool to measure compassionate care (i.e. using Confirmatory Factor Analysis), to ascertain the validity and reliability of the tool with a sample of health and social care service providers, and to more stringently examine the psychometric properties of the tool (i.e. convergent and divergent validity, test-retest reliability).
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