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Evaluating paramedic comfort with field pronouncement: development and validation of an outcome measure.

OBJECTIVES
Interventions designed to improve cardiac resuscitation and the quality of field pronouncement need to consider outcomes on paramedic providers. The authors developed and evaluated the reliability and validity of a survey instrument measuring paramedic comfort with field pronouncement.


METHODS
A mail survey of 120 paramedics (EMT-Ps) was performed using the Modified Dillman survey methodology. Questions were sorted for analysis into subgroups assessing psychological comfort and technical skills. Sixty-five respondents were retested within two weeks.


RESULTS
The overall response rate was 96% (115). Respondents had an average age of 36 years (SD +/- 5), with 5.2 years (SD +/- 3.8) of out-of-hospital experience as an EMT-P, and were involved in a median of ten field pronouncements annually (range = 2-60). The face and content validity of the survey instrument was consistent with a content matrix derived by a focus group. The Cronbach's alpha for the survey instrument was 0.91. The retest response rate was 76% (46). The test-retest reliability coefficient was 0.84.


CONCLUSIONS
This survey is a valid and reliable instrument for measuring the paramedic psychological comfort with field pronouncement. The high response rate and intrareliability support its generalizability. This outcome measure may be helpful in evaluating the psychological impact of changes to emergency medical services (EMS) policy with respect to termination of resuscitation promoted by the National Association of EMS Physicians.