METHODS
Design, Sample, and Setting
A cross-sectional descriptive survey was taken that
used a self-administered questionnaire.
The target population was nurses and physicians
currently working in hospitals in Lebanon. Participants
were chosen from 15 hospitals geographically
spread in Lebanon, 4 of which are academic hospitals
located in Beirut, the capital. A contact person was
designated per hospital to distribute and collect
questionnaires. This was done in close collaboration
with the syndicate of private hospitals in Lebanon.
Institutional Review Board approval was granted
by all hospitals.
Data Collection Procedures
The sample size determination was based on a power
of 80%, alpha of 5%, and a precision (effect size) of
3%, with a baseline proportion of .5 (used when the
proportion is not known). The calculated sample
size was 1,056, but to account for nonresponse rates,
all nurses and physicians in the selected hospitals
were included in the study. A total of 3,757 (1,873
nurses and 1,884 physicians) questionnaires were
sent between November 2005 and January 2006
with a cover letter written by the first author describing
the goals of the study, name of the contact person,
and a time frame of 2 weeks for returning the questionnaire.
A reminder was sent after 2 weeks and
deadline extended to 2 months due to the low response
rate.
Questionnaire
The questionnaire, designed especially for this study,
was developed based on a review of the literature and
information gained from a qualitative study conducted
by the principal investigator. Content validity
and appropriateness for use in Lebanon was established
by a team of experts. It was pilot tested for
feasibility and clarity.
Because the educational background of nurses and
physicians in Lebanon is either English or French,
the questionnaire was developed in both languages.
It includes six sections: general information on specialty
area; perceptions and knowledge; attitudes,
practice, and needs assessment for PC services, and
two open-ended questions on the best model for delivering
PC and general comments