Schmitz Julia, Tewes Mitra, Mathew Baicy, Bubel Marie, Kill Clemens, Risse Joachim, Huessler Eva-Maria, Kowall Bernd, Salvador Comino Maria Rosa
Department of Palliative Medicine, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany.
Center of Emergency Medicine, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany.
J Clin Med. 2025 Mar 23;14(7):2191. doi: 10.3390/jcm14072191.
: The "Palliative Care and Rapid Emergency Screening Tool" (P-CaRES) is used to identify patients with palliative needs in the emergency department. This study aims to translate, adapt, and validate the P-CaRES tool for the German healthcare context. : This is a monocentric, non-interventional, retrospective study conducted in the emergency department of the University Hospital Essen, Germany. After a structured translation process, the tool's face and content validity were evaluated using questionnaires completed by healthcare workers. Construct validity was established by comparing the results with the German-validated Supportive and Palliative Care Indicators Tool (SPICT). A palliative care physician blinded to the tool, independently assessed the screened patients, and made recommendations on the appropriateness of palliative care referrals. : Two hundred eighty-nine emergency department visits were examined. In addition, a total of 26 healthcare professionals were surveyed. 258 screenings were conducted, with P-CaRES identifying 50 positive cases (19.4%). Agreement between SPICT and P-CaRES was 88.4% (kappa: 0.67, 95% confidence interval (CI): [0.56, 0.78]), showing 64.7% sensitivity and 96.8% specificity. Expert comparison yielded 85.5% agreement (kappa: 0.54, 95% CI: [0.41, 0.68]), with 64.0% sensitivity and 90.8% specificity. Face and content validity showed strong agreement regarding the tool's design, including its comprehensibility, applicability, ease of use, and precision, as well as its usefulness in referring patients to a specialized palliative care team. : The study successfully validated a cultural and linguistic equivalent German version of the P-CaRES tool. Further research is necessary to assess the tool's effectiveness in clinical practice.
“姑息治疗与快速急诊筛查工具”（P-CaRES）用于在急诊科识别有姑息治疗需求的患者。本研究旨在针对德国医疗环境对P-CaRES工具进行翻译、改编和验证。 ：这是一项在德国埃森大学医院急诊科进行的单中心、非干预性回顾性研究。经过结构化翻译过程后，使用医护人员填写的问卷对该工具的表面效度和内容效度进行评估。通过将结果与经德国验证的支持性和姑息治疗指标工具（SPICT）进行比较来确定结构效度。一名对该工具不知情的姑息治疗医生独立评估筛查的患者，并就姑息治疗转诊的适宜性提出建议。 ：对289次急诊科就诊进行了检查。此外，共对26名医疗专业人员进行了调查。进行了258次筛查，P-CaRES识别出50例阳性病例（19.4%）。SPICT与P-CaRES之间的一致性为88.4%（kappa值：0.67，95%置信区间（CI）：[0.56, 0.78]），灵敏度为64.7%，特异度为96.8%。专家比较的一致性为85.5%（kappa值：0.54，95%CI：[0.41, 0.68]），灵敏度为64.0%，特异度为90.8%。表面效度和内容效度在工具设计方面表现出高度一致性，包括其可理解性、适用性、易用性和精确性，以及在将患者转诊至专业姑息治疗团队方面的有用性。 ：该研究成功验证了P-CaRES工具的文化和语言等效德文版本。有必要进行进一步研究以评估该工具在临床实践中的有效性。
