Duke-NUS Medical School, Singapore, Singapore.
Tampere University, Tampere, Finland.
BMC Palliat Care. 2021 Mar 9;20(1):40. doi: 10.1186/s12904-021-00737-y.
Measurement of patient-centred outcomes enables clinicians to focus on patient and family priorities and enables quality of palliative care to be assessed.
This study aimed to evaluate the validity and reliability of the English and translated Chinese versions of the Integrated Palliative care Outcome Scale (IPOS) among advanced cancer patients in Singapore.
IPOS was forward and backward translated from English into Chinese. Structural validity was assessed by confirmatory factor analysis; known-group validity by comparing inpatients and community patients; construct validity by correlating IPOS with Edmonton Symptom Assessment System-revised (ESAS-r) and Functional Assessment of Cancer Therapy-General (FACT-G); internal consistency by Cronbach's alpha; inter-rater reliability between patient and staff responses; test-retest reliability of patient responses between two timepoints.
One hundred eleven English-responding and 109 Chinese-responding patients participated. The three-factor structure (Physical Symptoms, Emotional Symptoms and Communication and Practical Issues) was confirmed with Comparative Fit Index and Tucker-Lewis-Index > 0.9 and Root Mean Square Error of Approximation < 0.08. Inpatients scored higher than outpatients as hypothesised. Construct validity (Pearson's correlation coefficient, r ≥ |0.608|) was shown between the related subscales of IPOS and FACT-G and ESAS-r. Internal consistency was confirmed for total and subscale scores (Cronbach's alpha≥0.84), except for the Communication and Practical Issues subscale (Cronbach's alpha = 0.29-0.65). Inter-rater reliability (Intra-class correlation coefficient [ICC] ≤ 0.43) between patient and staff responses was insufficient. Test-retest reliability was confirmed with Intra-class correlation coefficient ICC = 0.80 (English) and 0.88 (Chinese) for IPOS Total.
IPOS in English and Chinese showed good validity, good internal consistency, and good test-retest reliability, except for the Communication and Practical Issues subscale. There was poor inter-rater reliability between patients and staff.
衡量以患者为中心的结果使临床医生能够关注患者和家属的优先事项，并能够评估姑息治疗的质量。
本研究旨在评估新加坡晚期癌症患者的综合姑息治疗结局量表（IPOS）的英文和中文翻译版本的效度和信度。
IPOS 从英文正向和反向翻译成中文。结构效度通过验证性因子分析进行评估；通过比较住院患者和社区患者评估已知组的有效性；通过将 IPOS 与埃德蒙顿症状评估系统修订版（ESAS-r）和癌症治疗功能评估一般量表（FACT-G）进行相关性分析评估构效关系；通过 Cronbach's alpha 评估内部一致性；患者和工作人员反应之间的评分者间信度；两次时间点之间患者反应的测试-重测信度。
共有 111 名英语应答者和 109 名中文应答者参加了研究。假设验证了三因素结构（身体症状、情绪症状和沟通与实际问题），比较拟合指数和 Tucker-Lewis 指数 >0.9，近似均方根误差 <0.08。住院患者的得分高于门诊患者，符合假设。结构效度（相关亚量表的 Pearson 相关系数，r≥|0.608|）显示 IPOS 与 FACT-G 和 ESAS-r 之间存在相关性。总分和子量表的内部一致性得到确认（Cronbach's alpha≥0.84），除沟通与实际问题子量表（Cronbach's alpha=0.29-0.65）外。患者和工作人员反应之间的评分者间信度（组内相关系数 [ICC]≤0.43）不足。测试-重测信度通过 IPOS 总分为英语的 ICC=0.80 和中文的 ICC=0.88 得到确认。
IPOS 的英文和中文版本表现出良好的效度、良好的内部一致性和良好的重测信度，除沟通与实际问题子量表外。患者和工作人员之间的评分者间信度较差。
