Faculty of Science, Medicine and Health, University of Wollongong, 239 Squires Way, Wollongong, 2522, New South Wales, Australia.
School of Nursing, Guilin Medical University, Guilin, Guangxi, China.
BMC Palliat Care. 2024 Apr 3;23(1):89. doi: 10.1186/s12904-024-01395-6.
A standardized national approach to routinely assessing palliative care patients helps improve patient outcomes. However, a quality improvement program-based on person centered outcomes within palliative care is lacking in Mainland China. The well-established Australian Palliative Care Outcome Collaboration (PCOC) national model improves palliative care quality. This study aimed to culturally adapt and validate three measures that form part of the PCOC program for palliative care clinical practice in China: The PCOC Symptom Assessment Scale (PCOC SAS), Palliative Care Problem Severity Scale (PCPSS), Palliative Care Phase.
A study was conducted on cross-cultural adaptation and validation of PCOC SAS, PCPSS and Palliative Care Phase, involving translation methods, cognitive interviewing, and psychometric testing through paired assessments.
Cross-cultural adaptation highlighted the need to strengthen the link between the patient's care plan and the outcome measures to improve outcomes, and the concept of distress in PCOC SAS. Analysis of 368 paired assessments (n = 135 inpatients, 22 clinicians) demonstrated that the PCOC SAS and PCPSS had good and acceptable coherence (Cronbach's a = 0.85, 0.75 respectively). Palliative Care Phase detected patients' urgent needs. PCOC SAS and PCPSS showed fair discriminant and concurrent validity. Inter-rater reliability was fair for Palliative Care Phase (k = 0.31) and PCPSS (k = 0.23-0.30), except for PCPSS-pain, which was moderate (k = 0.53).
The Chinese version of PCOC SAS, PCPSS, and Palliative Care Phase can be used to assess outcomes as part of routine clinical practice in Mainland China. Comprehensive clinical education regarding the assessment tools is necessary to help improve the inter-rater reliability.
常规评估姑息治疗患者的标准化国家方法有助于改善患者的结局。然而，中国大陆缺乏基于姑息治疗以患者为中心的结局的质量改进计划。已确立的澳大利亚姑息治疗结局协作（PCOC）国家模式可改善姑息治疗质量。本研究旨在对构成 PCOC 计划的三个部分进行文化适应和验证，该计划用于姑息治疗临床实践：PCOC 症状评估量表（PCOC SAS）、姑息治疗问题严重程度量表（PCPSS）、姑息治疗阶段。
进行了 PCOC SAS、PCPSS 和姑息治疗阶段的跨文化适应和验证研究，涉及翻译方法、认知访谈以及通过配对评估进行心理测量测试。
跨文化适应强调需要加强患者护理计划和结局测量之间的联系，以改善结局，并加强 PCOC SAS 中的痛苦概念。对 368 对配对评估（n=135 名住院患者，22 名临床医生）的分析表明，PCOC SAS 和 PCPSS 具有良好和可接受的一致性（Cronbach's a 分别为 0.85 和 0.75）。姑息治疗阶段检测到患者的紧急需求。PCOC SAS 和 PCPSS 显示出公平的区分和同时有效性。姑息治疗阶段（k=0.31）和 PCPSS（k=0.23-0.30）的评分者间可靠性为公平，除了 PCPSS-疼痛，其为中度（k=0.53）。
PCOC SAS、PCPSS 和姑息治疗阶段的中文版本可用于评估中国大陆常规临床实践中的结局。需要进行全面的临床教育，以帮助提高评分者间可靠性。
