THE HIV QUALITY AUDIT MARKER (HIV-QAM) - AN OUTCOME MEASURE FOR HOSPITALIZED AIDS PATIENTS

The development and validation of the HIV-Quality Audit Marker (HIV-QA M), an instrument designed to measure changes in the status of hospita lized AIDS patients due to nusing care, is reported. The HIV-QAM is de signed to capture the nurse data-collector's judgment of the status of the patient based upon observations, interviews, record reviews, and listening to inter-shift report. The final version of the 10 item HIV- QAM includes three scales, Self-care (six items; Cronbach's alpha = 0. 89), Ambulation (two items, alpha = 0.88), and Psychological Distress (two items, alpha = 0.84). Content validity was supported by selection of items from pre-existing scales, generation of items based on care plans for HIV/AIDS patients, and review and critique of items by a pan el of nurse experts. Construct validity was supported by principal com ponents factor analysis and multi-trait scaling analysis. Convergent a nd divergent concurrent validity with patient symptoms and intensity o f nursing care required was demonstrated. The predictive validity of t he HIV-QAM for mortality at 3 and 6 months after hospital treatment fo r Pneumocystis carinii pneumonia was also shown.