Table 2 Selected participant responses to general questions asked during the validation process (November 2017 – March 2018).
Question | Participant Responses |
|---|---|
Is there anything in the questionnaire that does not reflect the clinical realties in a Trinidad and Tobago context? | • Questions appear to reflect American culture and laws. • Questions assume that physicians practice some sort of palliative care. • The questionnaire is generic but suitable for the expertise that exists amongst most physicians. • General practitioners who do not regularly provide EOLC may take a longer time to complete the questionnaire. • Some physicians may not be aware of what the terms withholding and withdrawing treatments are in an EOLC situation. • We do not have a referral pathway for palliative care particularly for physicians not working in institutions. • There is no continuity of care and asking questions that relate to patient care, e.g., ‘within the last 30 days’ becomes difficult to trace or track. • The lack of DNR policies corners physicians to continue doing everything to save life, especially in an institutional setting. • A lack of regulations makes it difficult to practice. • Resources like drugs used in EOLC situations are not radially available, e.g., Propofol, morphine and other opioids, and there is a lack of human resources, e.g., counsellors and home care providers. • There are no on-call palliative care physicians, they are all only by referral. • There are not enough inpatient services to match the number of deaths that may require palliative care. • There are no hospices in Tobago. • There is little formal training for the family to care for patients at home. |
Are the questions presented in a logical sequence? If not, how could it be improved? | • Some participants thought the sections on ‘care and treatment’ and ‘medical practice’ should be combined. |
Does the questionnaire take too long to complete? | • No, there appears to be a lot of questions but it does not take long to complete. |
Are the routing directions (e.g., go to question x) clear enough? | • Yes, instructions are helpful. |
Is the layout and organisation confusing? If so, how can it be improved? | • The background colour should be changed. • Font size should be increased. |