scholarly journals Psychological Well-Being and Quality of Care: A Factor-Analytic Examination of the Palliative Care Outcome Scale

2010 ◽  
Vol 40 (1) ◽  
pp. 67-74 ◽  
Author(s):  
Richard J. Siegert ◽  
Wei Gao ◽  
Frank H. Walkey ◽  
Irene J. Higginson
Keyword(s):  
Palliative Care ◽  
Quality Of Care ◽  
Well Being ◽  
Psychological Well Being ◽  
Factor Analytic ◽  
Palliative Care Outcome Scale ◽  
Care Outcome

Implementing a patient-centred outcome measure in daily routine in a specialist palliative care inpatient hospital unit: An observational study

2016 ◽  
Vol 31 (3) ◽  
pp. 275-282 ◽  
Author(s):  
Alze Pereira dos Santos Tavares ◽  
Carolina Paparelli ◽  
Carolina Sassaki Kishimoto ◽  
Silvia Avo Cortizo ◽  
Karen Ebina ◽  
...  
Keyword(s):  
Palliative Care ◽  
Quality Of Care ◽  
Missing Data ◽  
Outcome Measure ◽  
Symptom Control ◽  
Daily Practice ◽  
Daily Routine ◽  
Palliative Care Outcome Scale ◽  
Care Outcome

Background: Gathering clinical evidence data on patients’ palliative care needs is paramount to identify changes in outcomes over time and maintaining on-going quality improvement. Implementation of patient-centred outcome measures has been widely recommended. The routine use of these instruments in daily practice is challenging and not widespread. Aim: To implement a patient-centred outcome measure in daily practice and fulfil one quality indicator: improve pain during the 72 h after admission, in at least 75% of patients. Design: An observational prospective study. The Palliative care Outcome Scale was used at admission (T0), third day (T1) and weekly. Setting/participants: Hospital palliative care unit with 17 individual rooms. All patients admitted to the unit were included in the study. Results: Preliminary results ( N = 84) revealed inconsistent and missing data (14%). Symptoms were sub-optimally controlled by T1. Processes changed, and only a team member could apply Palliative care Outcome Scale. Doctors were encouraged to grasp the meaning of Palliative care Outcome Scale results for each patient. The post-pilot included 317 patients. No missing data occurred. There was an improvement in most items between T0 and T1: ‘pain’ and ‘other symptoms’ presented statistical significant differences ( p < 0.05). Conclusion: Implementing a patient-centred outcome measure in a hospital palliative care service is feasible and improves quality of care. Controlling high pain at T0 improved (>80%) by T1. Results became more consistent and symptom control was improved overall. Patients are evaluated based on holistic domains by an interdisciplinary team and we have added a much needed measure to help guide improvement of the quality of care provided.

scholarly journals Towards patient-centred cancer care: cross-cultural validity and responsiveness of the Turkish Integrated Palliative care Outcome Scale

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Mevhibe B. Hocaoglu ◽  
Nilay Hepgul ◽  
India Tunnard ◽  
Emine Meltem ◽  
Hande Efe ◽  
...  
Keyword(s):  
Palliative Care ◽  
Quality Of Care ◽  
Cancer Patients ◽  
Factor Structure ◽  
Internal Consistency ◽  
Cross Cultural ◽  
Cultural Validity ◽  
Palliative Care Outcome Scale ◽  
Care Outcome

Abstract Background A valid measure to describe the most important needs and concerns of people with life-threatening illnesses is missing in Cyprus. Our aim was to adapt and test the cross-cultural validity and responsiveness of the Integrated Palliative care Outcome Scale (IPOS) in a cohort of Turkish speaking cancer patients. Methods The IPOS (English) patient-reported measure was translated into Turkish following published guidelines including, 2 independent forward, 2 independent blind backward translations, expert panel review by 7 members and field testing with 11 cognitive interviews (5 patients and 6 specialists) and final approval of the copyright holder. Consecutive cancer patients (n = 234) seen by the community palliative care services were recruited from Help Those with Cancer Society (KHYD); of those 82 were followed-up. The instrument was administered by personal interview. Confirmatory Factor Analysis was used to validate the factor structure of Turkish IPOS. Internal consistency reliability of the subscales was evaluated by Cronbach’s alpha and Intraclass Correlation Coefficient respectively. Validity was assessed by calculating Pearson’s correlation coefficient (r) between Turkish IPOS scores and Turkish version of EQ-5D-3L - a validated generic measure of health status developed by the EuroQol Group. Results Turkish IPOS is conceptually and semantically equivalent to the English version and linguistically valid. The CFA was inconclusive for the three factor structure due to low sample size, as the SRMR and CFI tests only approached the defined minimums warranting further investigation. There were low levels of missing values, and no ceiling or floor effects. The Physical (α = 0.91) and the Social and Quality of Care Issues (α = 0.75) sub-scales showed good internal consistencies, however Emotional sub-scale showed poor internal consistency (α = 0.64). The reliability of the Physical (ICC = 0.51, 0.45–0.56 95% CI) and Social Quality of Care Issues (ICC = 0.50, 0.42–0.57 95% CI) were moderate. Poor internal consistency (α =0.64) and reliability (ICC = 0.31, 0.24–0.39, 95% CI) was obtained for Emotional Subscale. Construct validity was evidenced through significant correlations in the predicted directions and strength with EQ-5D. Turkish IPOS showed higher needs and concerns in participants at more advanced stages than those at earlier stages of cancer. The standardized response mean (SRM) of − 0.94 suggested large internal responsiveness to clinical change. Conclusion Turkish IPOS is a clear, relevant, acceptable measure and responsive to the needs and concerns of cancer patients, observing regional differences, it may have implications for use in other Turkish speaking communities. Future studies are needed to clarify the factor structure, assess its external responsiveness and to improve the properties of its Emotional subscale.

Peripherally inserted central catheter, midline, and “short” midline in palliative care: Patient-reported outcome measures to assess impact on quality of care

2018 ◽  
Vol 20 (5) ◽  
pp. 475-481 ◽  
Author(s):  
Caterina Magnani ◽  
Alice Calvieri ◽  
Diana Giannarelli ◽  
Margot Espino ◽  
Giuseppe Casale
Keyword(s):  
Palliative Care ◽  
Quality Of Care ◽  
Scale Score ◽  
Vascular Access ◽  
Access Device ◽  
Palliative Care Outcome Scale ◽  
Vascular Access Device ◽  
The Impact ◽  
Care Outcome

Objectives: A prospective, observational study was conducted in our palliative care unit to assess the impact of peripherally inserted central catheters (PICCs), midline, and “short” midline catheters on the quality of care in cancer and non-cancer patients. The secondary objective was to assess pain and distress during vascular access device insertion. Methods: Patients were recruited if they underwent insertion of a PICC, midline, or “short” midline catheter as part of their standard care. The Palliative care Outcome Scale was used to assess changes in quality of care after vascular access device positioning. A numerical rating scale was used to measure pain intensity during catheter insertion. Results: Of the 90 patients enrolled, 52.2% were male with a mean age of 73.0 ± 13 years. Among these patients, 64.4% patients underwent “short” midline insertion, 26.7% PICC, and 8.9% midline catheter. The patients’ mean baseline Palliative care Outcome Scale score was 15.7 ± 5.6. Three days after vascular access device positioning, the patients’ mean Palliative care Outcome Scale score was 11.5 ± 5.5 (p < 0.0001). Mean pain score during vascular access device insertion was 1.26 ± 1.63, and mean procedural distress score was 1.78 ± 1.93. Conclusion: These findings suggest that medium-term intravenous catheters can have a favorable impact on quality of care and the procedures for these vascular access device insertions are well tolerated. Further research on the performance of different vascular access devices and their appropriateness in palliative care should be encouraged.

scholarly journals Translation and cultural adaptation of IPOS (integrated palliative care outcome scale) in Estonia

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Merli Laissaar ◽  
Riina Hallik ◽  
Pille Sillaste ◽  
Ulvi Ragun ◽  
Mari-Leen Pärn ◽  
...  
Keyword(s):  
Palliative Care ◽  
Well Being ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Cognitive Interviews ◽  
Adaptation Process ◽  
Team Members ◽  
Palliative Care Outcome Scale ◽  
Patient Reported ◽  
Care Outcome

Abstract Background Patient Reported Outcome Measures (PROMs) are questionnaires that could be used in palliative care (PC) to evaluate patient well-being and monitor their care. PROMs enable a focus on what is important to patients by putting the patient at the center of care. Adapting an existing PROM requires considering cultural differences, general usability and understandability of translated terms. Aim To translate and culturally adapt both the patient and staff three and seven day versions of the Integrated Palliative care Outcome Scale (IPOS) into Estonian. The IPOS consist of 10 questions (staff versions 9 questions) and 17 close ended items. The sub aim is to describe the differences and discrepancies found during the adaptation process and compare the results with previous research. Methods The translation and adaptation process of IPOS was conducted using recommended guidelines consisting of six phases and included cognitive interviews with patients (n = 11) and palliative care multidisciplinary team members (n = 8). The study was conducted in two major Estonian hospitals. Results The Estonian IPOS demonstrated face and content validity, acceptance by patients and staff. As a result of expert group review and cognitive interviews with patients and staff, 9 semantic changes were implemented. Conclusions Patient and staff versions of the IPOS with a recall of 3 or 7 days were translated and culturally adapted for Estonia. The Estonian IPOS four versions are ready for use in Estonia.

Fear, anxiety, and adjustment disorder in palliative care

2021 ◽  
pp. 756-763
Author(s):  
Kerry A. Sherman ◽  
Christopher J. Kilby
Keyword(s):  
Palliative Care ◽  
Information Provision ◽  
Well Being ◽  
Healthcare Team ◽  
Open Communication ◽  
Psychological Well Being ◽  
Difficult Time ◽  
Spiritual Well Being ◽  
Quality Of Death

Palliative care has major implications for the psychological well-being of not only the patient, but also family members and those close to them. Being offered palliative care can send a variety of signals to a patient, including a sense that the medical system has failed them and that their life is about to end, or maybe a sense of relief in knowing that their suffering will end soon. The family of the patient also experience a range of emotions associated with palliative care, often mimicking that of the patient. Although palliative care aims to minimize suffering and improve the quality of death for the patient, it is critical that the psychosocial well-being of the patient is addressed; neglect of these concerns will compromise the quality of palliative care, the quality of death, and overall psychological, emotional, and spiritual well-being of the patient, despite improvements in physical suffering. This chapter discusses the key importance of the need for reciprocal open communication and information provision during this difficult time between the patient, their family, and the palliative healthcare team. Ineffective communication can jeopardize the psychosocial well-being of the patient, with feelings of existential threat, isolation, depression, fear, anxiety, hopelessness, and wishing for a hastened death commonly reported. This chapter highlights these issues and provides an overview of evidence-based established approaches addressing the psychological well-being of both the patient and their family. An overarching theme across all intervention approaches is to maintain honest, open communication between medical staff, the patient, and their family.

Psychological well-being in palliative care: A systematic review

2021 ◽  
pp. 003022282110192
Author(s):  
Tamara Redondo Elvira ◽  
Celia Ibáñez del Prado ◽  
Juan Antonio Cruzado
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Palliative Care ◽  
End Of Life ◽  
Well Being ◽  
Psychological Well Being ◽  
Predictive Variables ◽  
Spiritual Well Being ◽  
Relevant Variables

Objective To review which are the most influential variables in achieving levels of psychological well-being at the end of life and to verify whether, as certain studies suggest, spirituality, resilience and social support are the pillars on which the psychological well-being construct is based. Method A systematic search through the Scopus, Pubmed and PsycInfo electronic databases was carried out using keywords such as: “wellbeing” OR “psychological-well-being” AND “resilience” AND “spirituality” AND “social support” AND “palliative care” and their multiple combinations. Results Eleven studies were selected, in which terms such as spiritual well-being, absence of discomfort and quality of life were used in substitution of psychological well-being and a certain consensus was found regarding whether resilience, spirituality and social support are predictive variables of psychological well-being. Conclusions Resilience, social support and spirituality are highly relevant variables at the end of life and contribute decisively towards psychological well-being.

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