Two instruments to measure interdisciplinary bioethical decision making.

Abstract

OBJECTIVE: To develop and test two instruments measuring decision making about level of aggressiveness of intensive care unit (ICU) patient care. Decisions about Aggressiveness of Patient Care (DAC) measures care providers' general perceptions about decision making. Decisions about Aggressiveness of Patient Care for Specific Patients (DAC[SP]) measures perceptions in specific situations. DESIGN: Two-phase psychometric instrument evaluation. SETTING: Phase I, nationally mailed questionnaire. Phase II, northeastern medical center medical ICU. SUBJECTS: Phase I, 22 ICU nurse and physician experts. Phase II, 35 medical ICU staff nurses and eight medical resident physicians. OUTCOME MEASURE: Psychometric properties of instruments. RESULTS: Content validity of both tools was supported by their development from the literature and by the experts. Face validity was supported by the experts, staff nurses, and medical resident physicians. Both instruments had variance in responses, internal consistency reliability (r = 0.53, r = 0.73) and, test-retest reliability (r = 0.73). CONCLUSION: These instruments may enrich our understanding of how care providers make bioethical decisions for ICU patients. Such understanding could assist with development of interventions to increase collaborative interdisciplinary decision making, leading to increased care provider satisfaction and better patient outcomes.