Guidelines for Constructing a Psychometric Index: Applied to the Compassionate Disclosure of (Perinatal) Loss (CDL) Index.

This methodological guide documents the development, scoring, psychometric evaluation, and application of the six-item Compassionate Disclosure of (Perinatal) Loss (CDL) Index. The CDL Index was developed to measure the degree of compassion and sensitivity with which healthcare providers communicate news of pregnancy or infant loss.

Using the CDL Index as an applied example, the guide describes construct definition; post hoc conceptual framing of domains identified through patient narratives and empirical analysis; item development; response coding; composite score construction; content validation; internal consistency testing; exploratory factor analysis; and analytical application.

In the RESPCCT study sample (n = 172), the CDL Index demonstrated good internal consistency (Cronbach’s α = 0.80) and a unidimensional factor structure. The six items form a composite score ranging from 0 to 6, with higher scores indicating more compassionate disclosure.

The resource is intended for researchers, clinicians, educators, and quality-improvement teams interested in psychometric index development, respectful maternity care, pregnancy loss, patient experience, and compassionate communication.

The CDL Index and accompanying guidelines are licensed under CC BY-NC 4.0. Users of the CDL Index should also cite the original study: Hall, Malhotra, Clark, Hodge, Griffith, & Vedam (2025), Inequities in Care During Pregnancy Loss: Empirical Insights From Experiences With Canadian Perinatal Care, Birth. https://doi.org/10.1111/birt.70020 

 https://nishamalhotra.com/pregnancy-loss-care-cdl-index/