Malcolm Masso1, Samuel Frederic Allingham2, Claire Elizabeth Johnson3, Tanya Pidgeon3, Patsy Yates4, David Currow5, Kathy Eagar2. 1. Centre for Health Service Development (CHSD), Australian Health Services Research Institute, University of Wollongong, Wollongong, NSW, Australia mmasso@uow.edu.au. 2. Palliative Care Outcomes Collaboration (PCOC), Australian Health Services Research Institute, University of Wollongong, Wollongong, NSW, Australia. 3. Cancer and Palliative Care Research and Evaluation Unit, School of Surgery, University of Western Australia, Perth, WA, Australia. 4. School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia. 5. Palliative and Supportive Services, Flinders University, Adelaide, SA, Australia.
Abstract
BACKGROUND: The Palliative Care Problem Severity Score is a clinician-rated tool to assess problem severity in four palliative care domains (pain, other symptoms, psychological/spiritual, family/carer problems) using a 4-point categorical scale (absent, mild, moderate, severe). AIM: To test the reliability and acceptability of the Palliative Care Problem Severity Score. DESIGN: Multi-centre, cross-sectional study involving pairs of clinicians independently rating problem severity using the tool. SETTING/PARTICIPANTS: Clinicians from 10 Australian palliative care services: 9 inpatient units and 1 mixed inpatient/community-based service. RESULTS: A total of 102 clinicians participated, with almost 600 paired assessments completed for each domain, involving 420 patients. A total of 91% of paired assessments were undertaken within 2 h. Strength of agreement for three of the four domains was moderate: pain (Kappa = 0.42, 95% confidence interval = 0.36 to 0.49); psychological/spiritual (Kappa = 0.48, 95% confidence interval = 0.42 to 0.54); family/carer (Kappa = 0.45, 95% confidence interval = 0.40 to 0.52). Strength of agreement for the remaining domain (other symptoms) was fair (Kappa = 0.38, 95% confidence interval = 0.32 to 0.45). CONCLUSION: The Palliative Care Problem Severity Score is an acceptable measure, with moderate reliability across three domains. Variability in inter-rater reliability across sites and participant feedback indicate that ongoing education is required to ensure that clinicians understand the purpose of the tool and each of its domains. Raters familiar with the patient they were assessing found it easier to assign problem severity, but this did not improve inter-rater reliability.
BACKGROUND: The Palliative Care Problem Severity Score is a clinician-rated tool to assess problem severity in four palliative care domains (pain, other symptoms, psychological/spiritual, family/carer problems) using a 4-point categorical scale (absent, mild, moderate, severe). AIM: To test the reliability and acceptability of the Palliative Care Problem Severity Score. DESIGN: Multi-centre, cross-sectional study involving pairs of clinicians independently rating problem severity using the tool. SETTING/PARTICIPANTS: Clinicians from 10 Australian palliative care services: 9 inpatient units and 1 mixed inpatient/community-based service. RESULTS: A total of 102 clinicians participated, with almost 600 paired assessments completed for each domain, involving 420 patients. A total of 91% of paired assessments were undertaken within 2 h. Strength of agreement for three of the four domains was moderate: pain (Kappa = 0.42, 95% confidence interval = 0.36 to 0.49); psychological/spiritual (Kappa = 0.48, 95% confidence interval = 0.42 to 0.54); family/carer (Kappa = 0.45, 95% confidence interval = 0.40 to 0.52). Strength of agreement for the remaining domain (other symptoms) was fair (Kappa = 0.38, 95% confidence interval = 0.32 to 0.45). CONCLUSION: The Palliative Care Problem Severity Score is an acceptable measure, with moderate reliability across three domains. Variability in inter-rater reliability across sites and participant feedback indicate that ongoing education is required to ensure that clinicians understand the purpose of the tool and each of its domains. Raters familiar with the patient they were assessing found it easier to assign problem severity, but this did not improve inter-rater reliability.
Authors: Aaron K Wong; Lucy Demediuk; Jia Y Tay; Olivia Wawryk; Anna Collins; Rachel Everitt; Jennifer Philip; Kirsty Buising; Brian Le Journal: Intern Med J Date: 2021-09 Impact factor: 2.611
Authors: John A Woods; Jade C Newton; Sandra C Thompson; Eva Malacova; Hanh T Ngo; Judith M Katzenellenbogen; Kevin Murray; Shaouli Shahid; Claire E Johnson Journal: PLoS One Date: 2019-05-02 Impact factor: 3.240
Authors: Xavier Busquet-Duran; Eva Maria Jiménez-Zafra; Josep Maria Manresa-Domínguez; Magda Tura-Poma; Olga Bosch-delaRosa; Anna Moragas-Roca; Maria Concepción Galera Padilla; Susana Martin Moreno; Emilio Martínez-Losada; Silvia Crespo-Ramírez; Ana Isabel López-Garcia; Pere Torán-Monserrat Journal: J Multidiscip Healthc Date: 2020-03-19
Authors: Barbara A Daveson; Samuel Frederic Allingham; Sabina Clapham; Claire E Johnson; David C Currow; Patsy Yates; Kathy Eagar Journal: PLoS One Date: 2021-03-25 Impact factor: 3.240
Authors: Xavier Busquet-Duran; Eva Maria Jiménez-Zafra; Magda Tura-Poma; Olga Bosch-de la Rosa; Anna Moragas-Roca; Susana Martin-Moreno; Emilio Martínez-Losada; Silvia Crespo-Ramírez; Lola Lestón-Lado; Núria Salamero-Tura; Joana Llobera-Estrany; Núria Oriol-Peregrina; Eduard Moreno-Gabriel; Josep Maria Manresa-Domínguez; Pere Torán-Monserrat Journal: Healthcare (Basel) Date: 2021-02-04