Creation, validation and psychometric properties of an Attitude Assessment Scale for bad news communication and its relationship with modulator behavioral factors

Abstract

Bad news is defined as any news that drastically and negatively alters the patient's view of his future, albeit temporarily. Difficulties in transmitting bad news can negatively affect both the patient and the doctor. Pediatrics is critical for bad news as the patient is not the recipient of the bad news, nor is he able to fully understand its consequences. It is accepted that bad news communication (BNC) can suffer interferences derived from the professional's psychological conditions, the setting and even their intuitive conceptions about what the procedure should be. Thus, to create an instrument that allows us to objectively verify how the professional considers the BNC opens the possibility of training so that it can produce evidence-based educational interventions. Thus, the present paper proposes an instrument for the assessment of the professional regarding their degree of concordance with the principles of the SPIKES protocol and its disposition for BNC training. An observational, quantitative study will be performed that will follow the guidelines of good practices in surveys and adopt the CHERRIES protocol for e-Surveys. The sample will be composed of pediatricians and their specialties and graduates. It will be proposed a questionnaire mapping and identification of concepts, knowledge, attitudes and individual perceptions about critical news and family approach. From this, will be proposed an attitude assessment scale for BNC based on the SPIKES protocol. Scale validation will be carried out by factorial analysis, with exploratory and confirmatory analysis and the necessary statistical model adjustment parameters. The premise of factorial analysis will be based on a sample universe of 10 participants per questionnaire item, which will be known only after the scale construction. Comparative measures of validation between scales will be performed with the Jefferson Scale of Medical Empathy. The psychometric properties will allow to objectively measure the attitude of medical professionals and medical students regarding CMN. This will be verified by the consistency levels that the instrument provided by the proposed factor analysis. The psychological characteristics verified will be stress, medical empathy, and self-efficacy. To verify the interfering psychological characteristics will be used validated instruments: Perceived Stress Scale (PSS); Jefferson's Scale of Medical Empathy and Perceived Self Efficacy Scale. The data collection will take place in a single moment. After validation of the main scale will be proposed correlations and structural models to verify the modulation or interference of the psychological characteristics in the attitudes for BNC. At the end of this study, we intend to identify the modulating factors in BNC capacity, as well as propose means for the proposed scale to be used in the formulation of teaching and continuing education proposals. To date, we have no information on the existence of an instrument such as the one proposed here and will serve as a basis for the development of evidence-based educational interventions. (AU)