Measuring needling experience: development and validation of the Needling Patient Reported Experience Measure (NPREM)

Abstract

Background and Aims: Most people on haemodialysis rely on having reliable access to their vascular system, often via surgically created arteriovenous fistula or graft. At the beginning of each dialysis session, needles must be inserted. While 'needling' is a key step, an annual UK survey shows that needling is one of the lowest scoring areas of reported experience for individuals receiving haemodialysis in a kidney centre or satellite unit. Qualitative research indicates that needling can be painful and cause anxiety. Although an emerging area of research, no validated measures exist which assess patient reported experience of needling. We aimed to develop a questionnaire which reliably measures needling experience. The Needling Patient Reported Experience Measure (NPREM) was developed over multiple phases consisting of qualitative interviews with patients, item generation involving a multidisciplinary expert group including experts by experience, cognitive interviewing and pilot testing. Here we report the results of the final validation phase.