Hearn J, Higginson I J
Department of Palliative Care and Policy, King's College School of Medicine and Dentistry, London, UK.
Qual Health Care. 1999 Dec;8(4):219-27. doi: 10.1136/qshc.8.4.219.
To develop an outcome measure for patients with advanced cancer and their families which would cover more than either physical symptoms or quality of life related questions. To validate the measure in various specialist and non-specialist palliative care settings throughout the UK.
A systematic literature review of measures appropriate for use in palliative care settings was conducted. In conjunction with a multidisciplinary project advisory group, questions were chosen for inclusion into the scale based on whether they measured aspects of physical, psychological, or spiritual domains pertinent to palliative care, and whether similar items had shown to be valid as part of another measure. A staff completed version was developed to facilitate data collection on all patients throughout their care, and a patient completed version was designed to enable the patient to contribute to the assessment of their outcomes when possible. A full validation study was conducted to evaluate construct validity, internal consistency, responsiveness to change over time, and test-retest reliability. Assessments were timed.
Eight centres in England and Scotland providing palliative care, including inpatient care, outpatient care, day care, home care, and primary care.
A total of 450 patients entered care during the study period. Staff collected data routinely on patients in care long enough to be assessed (n = 337). Of these, 262 were eligible for patient participation; 148 (33%) went on to complete a questionnaire.
The Palliative Care Outcome Scale (POS), the European Organisation for Research on Cancer Treatment, and the Support Team Assessment Schedule.
The POS consists of two almost identical measures, one of which is completed by staff, the other by patients. Agreement between staff and patient ratings was found to be acceptable for eight out of 10 items at the first assessment. The measure demonstrated construct validity (Spearman rho = 0.43 to 0.80). Test/re-test reliability was acceptable for seven items. Internal consistency was good (Cronbach's alpha = 0.65 (patients), 0.70 (staff)). Change over time was shown, but did not reach statistical significance. The questionnaire did not take more than 10 minutes to complete by staff or patients.
The POS has acceptable validity and reliability. It can be used to assess prospectively palliative care for patients with advanced cancer.
为晚期癌症患者及其家属制定一种结果测量方法，该方法涵盖的内容应超出身体症状或生活质量相关问题。在英国各地的各种专科和非专科姑息治疗环境中验证该测量方法。
对适用于姑息治疗环境的测量方法进行系统的文献综述。与多学科项目咨询小组合作，根据问题是否测量了与姑息治疗相关的身体、心理或精神领域的方面，以及类似项目作为另一测量方法的一部分是否已被证明有效，选择问题纳入量表。开发了一个由工作人员填写的版本，以方便在患者整个护理过程中收集所有患者的数据，还设计了一个由患者填写的版本，以便患者在可能的情况下参与对其结果的评估。进行了一项全面的验证研究，以评估结构效度、内部一致性、随时间变化的反应性以及重测信度。评估是定时的。
英格兰和苏格兰的八个提供姑息治疗的中心，包括住院护理、门诊护理、日间护理、家庭护理和初级护理。
在研究期间，共有450名患者接受护理。工作人员对接受护理时间足够长以进行评估的患者常规收集数据（n = 337）。其中，262名患者符合患者参与条件；148名（33%）继续完成了问卷调查。
姑息治疗结果量表（POS）、欧洲癌症研究与治疗组织以及支持团队评估表。
POS由两个几乎相同的测量方法组成，其中一个由工作人员完成，另一个由患者完成。在首次评估时，10个项目中的8个项目中，工作人员和患者评分之间的一致性被认为是可接受的。该测量方法显示出结构效度（斯皮尔曼相关系数 = 0.43至0.80）。7个项目的重测信度是可接受的。内部一致性良好（克朗巴赫α系数 = 0.65（患者），0.70（工作人员））。显示出随时间的变化，但未达到统计学显著性。工作人员或患者完成问卷的时间不超过10分钟。
POS具有可接受的效度和信度。它可用于前瞻性评估晚期癌症患者的姑息治疗。
