Development of a tool to assess fidelity to a psycho‐educational intervention

Mi‐Kyung Song · Mary Beth Happ · Margarete Sandelowski

70 citations0/0 files storedJournal of Advanced Nursing

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Health Education and Validation Health Sciences Research and Education Health Policy Implementation Science

Abstract

AIM: This paper is a description of a method to develop and conduct a customized psycho-educational intervention fidelity assessment as part of pilot work for an efficacy study. A tool designed to assess treatment fidelity to a psycho-education intervention for patients with end-stage renal disease and their surrogate decision makers, Sharing the Patient's Illness Representations to Increase Trust, is presented as an illustration. BACKGROUND: Despite the specificity and idiosyncrasy of individual interventions and the call to systematically evaluate treatment fidelity, how to accomplish this goal has not been clarified. Tools to adequately measure treatment fidelity are lacking. METHODS: We developed the Sharing the Patient's Illness Representations to Increase Trust Treatment Fidelity Assessment tool by identifying elements that were idiosyncratic to the intervention and those that could be adapted from existing tools. The tool has four components: overall adherence to the intervention content elements; pacing of the intervention delivery; overall dyad responsiveness; and, overall quality index of intervention delivery. The study was undertaken between 2006 and 2008. RESULTS: Inter-rater reliability ranged from 0.80 to 0.87 for the four components. The tool showed utility in training and monitoring, such as detecting unplanned content elements delivered and the use of proscribed communication behaviours. CONCLUSION: Psycho-educational interventions are one of the most common types of nursing interventions worldwide. Use of fidelity assessment tools customized to the individual interventions may enhance systematic evaluation of training and monitoring treatment fidelity.

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References

1977The Measurement of Observer Agreement for Categorical Data 1989Health Measurement Scales: A Practical Guide to Their Development and Use 2003Health Measurement Scales 1993Testing the integrity of a psychotherapy protocol: Assessment of adherence and competence.1991Treatment fidelity in outcome studies 2005Treatment Integrity and Therapeutic Change: Issues and Research Recommendations 2005Evaluating fidelity: Predictive validity for a measure of competent adherence to the oregon model of parent management training 2008Manual for the Motivational Interviewing Skill Code (MISC)

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