European migrant populations are aging and will increasingly be in need of palliative and end of life care. However, migrant patients are often underrepresented in palliative care research populations. This poses a number of drawbacks, such as the inability to generalize findings or check the appropriateness of care innovations amongst migrant patients. The aim of this study was to develop a self-assessment instrument to help palliative care researchers assess and find ways to improve their projects’ diversity responsiveness in light of the aging migrant population, and determine whether in addition to older migrants other groups should be included in the instrument’s focus. After developing a concept instrument based on the standards for equity in healthcare for migrants and other vulnerable groups, literature review and interviews with palliative care researchers, we conducted a Delphi study to establish the content of the self-assessment instrument and used think aloud methods in a study involving seven projects for usability testing of the self-assessment instrument. A Delphi panel of 22 experts responded to a questionnaire consisting of 3 items concerning the target group and 30 items on diversity responsiveness measures. Using an a priori set consensus rate of 75% to include items in the self-assessment instrument, experts reached consensus on 25 out of 30 items on diversity responsiveness measures. Findings furthermore indicate that underserved groups in palliative care other than migrant patients should be included in the instrument’s focus. This was stressed by both the experts involved in the Delphi study and the researchers engaged in usability testing. Usability testing additionally provided insights into learnability, error-rate, satisfaction and applicability of the instrument, which were used to revise the self-assessment instrument. The final self-assessment instrument includes a list of 23 diversity responsiveness measures to be taken at varying stages of a project, and targets all groups at risk of being underrepresented. This instrument can be used in palliative care research to assess diversity responsiveness of projects and instigate action for improvement.

中文翻译：

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如何帮助姑息治疗研究人员提高对移民和其他代表性不足人群的反应能力：开发和测试自我评估工具

欧洲移民人口正在老龄化，将越来越需要姑息治疗和临终关怀。但是，在姑息治疗研究人群中，移徙患者的人数通常不足。这带来了许多缺点，例如无法概括调查结果或无法检查移徙患者中护理创新的适当性。这项研究的目的是开发一种自我评估工具，以帮助姑息治疗研究人员根据移民人口的老龄化情况评估并找到改善项目多样性反应能力的方法，并确定除老年移民外，是否还应包括其他群体在仪器的焦点上。在根据移民和其他弱势群体的医疗保健公平标准制定了概念工具之后，通过文献回顾和对姑息治疗研究人员的访谈，我们进行了德尔菲研究以建立自我评估工具的内容，并在一项涉及七个用于自我评估工具可用性测试的项目的研究中使用了大声思考的方法。一个由22位专家组成的德尔菲小组对一个调查表进行了回复，该调查表包括3个与目标群体有关的项目和30个关于多样性响应措施的项目。使用预先设定的75％共识率将各项纳入自我评估工具，专家们就30种多样性响应措施中的25项达成了共识。研究结果还表明，姑息治疗中服务不足的人群（而非移徙患者）应纳入该工具的关注范围。参与Delphi研究的专家和从事可用性测试的研究人员都强调了这一点。可用性测试还提供了对工具的可学习性，错误率，满意度和适用性的见解，这些信息被用于修改自我评估工具。最终的自我评估工具包括在项目的不同阶段要采取的23种多样性响应措施的清单，并针对所有代表性不足的群体。该工具可用于姑息治疗研究中，以评估项目的多样性响应能力，并鼓励采取改善措施。最终的自我评估工具包括在项目的不同阶段要采取的23种多样性响应措施的清单，并针对所有代表性不足的群体。该工具可用于姑息治疗研究中，以评估项目的多样性响应能力，并鼓励采取改善措施。最终的自我评估工具包括在项目的不同阶段要采取的23种多样性响应措施的清单，并针对所有代表性不足的群体。该工具可用于姑息治疗研究中，以评估项目的多样性响应能力，并鼓励采取改善措施。