The Construct Validity of the Social and Spiritual Items of the Utrecht Symptom Diary – 4 Dimensional

ackground/aims: Patients facing a life-limiting illness experience multidimensional symptoms, problems, and needs requiring personalized
care. The Utrecht Symptom Diary-4 Dimensional (USD-4D) is a Patient
Reported Outcome Measure (PROM) that supports multidimensional
symptom management through identification, monitoring and discussing of multidimensional symptoms and concerns. Construct validity is
defined as the “degree to which the scores of a PROM are consistent
with hypotheses based on the assumption that the PROM validly measures the construct to be measured.”
Aim: To establish the construct validity of the social and spiritual items
of the USD-4D
Methods: A retrospective analysis of data from two cohorts: 1) hospice
cohort and 2) MuSt-PC cohort,. Patients included in the hospice cohort
were adult patients, admitted to hospice, with an estimated life-expectancy < 3 months . The MuSt-PC cohort comprised adult patients with
an estimated life-expectancy of < 12 months in the home, care home,
hospital, or hospice setting. Since the USD-4D does not measure a single
construct, the construct validity was assessed through hypotheses testing per item, following the criteria of the COSMIN initiative (COnsensus based Standards for the selection of health Measurement Instruments).
Construct validity was established when ⩾75% of the hypotheses were
confirmed. A total of 19 hypotheses were formulated and tested.
Results: 897 patients were included in the final analysis. Of these
patients 53% was female, 81% had cancer as their primary diagnosis and
85% received care in a hospice. For all but one item, 100% of hypotheses
were confirmed. Only, one hypothesis for the item ‘I can let my loved
ones go’ was rejected, resulting in 75% of hypotheses confirmed for this
item.
Conclusions: This study confirmed the construct validity on the social
and spiritual items of the USD-4D for Dutch hospice patients in the palliative phase of their illness. The USD-4D is suitable for monitoring multidimensional symptoms and needs.