Development and psychometric evaluation of the DysPalKT for assessing nurses’ knowledge of dyspnoea care in patients with cancer receiving palliative care

Dyspnoea is one of the most prevalent and distressing symptoms among patients with advanced cancer receiving palliative care. Nurses, particularly in non-specialist settings, often report insufficient preparedness in managing dyspnoea. Despite its clinical relevance, existing tests inadequately assess nurses’ knowledge of dyspnoea care. This study aimed to develop and evaluate the Knowledge of Dyspnoea Care in Patients with Cancer Receiving Palliative Care (DysPalKT) to address this gap. The DysPalKT was developed through a multi method approach including literature synthesis, expert panel validation, and pilot testing. A cross-sectional psychometric evaluation was conducted with 84 registered nurses working in general inpatient wards across seven district hospitals in Finland. Psychometric properties were analysed using the Kuder-Richardson Formula 20 (KR-20) and Rasch modelling. The final test comprised 16 items across three domains. Content validity was supported by expert evaluations (I-CVI ≥ 0.83). However, KR-20 (0.306) indicated weak internal consistency, and Rasch analysis revealed low person separation and multidimensionality. Most items were too easy, limiting the test’s ability to differentiate between knowledge levels. The DysPalKT shows promise for assessing nurses’ knowledge of dyspnoea care in palliative care settings, but further refinement is needed. Increasing item difficulty and expanding the item pool may improve its reliability and discriminatory power. These improvements could enhance the knowledge test’s ability to identify learning needs, thereby supporting the design and targeting of future educational interventions in non-specialist palliative care.