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Laissaar M, Hallik R, Sillaste P, Ragun U, Pärn ML, Suija K. Translation and cultural adaptation of IPOS (integrated palliative care outcome scale) in Estonia. J Patient Rep Outcomes 2021; 5:15. [PMID: 33507419 PMCID: PMC7841376 DOI: 10.1186/s41687-021-00288-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 01/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patient Reported Outcome Measures (PROMs) are questionnaires that could be used in palliative care (PC) to evaluate patient well-being and monitor their care. PROMs enable a focus on what is important to patients by putting the patient at the center of care. Adapting an existing PROM requires considering cultural differences, general usability and understandability of translated terms. AIM To translate and culturally adapt both the patient and staff three and seven day versions of the Integrated Palliative care Outcome Scale (IPOS) into Estonian. The IPOS consist of 10 questions (staff versions 9 questions) and 17 close ended items. The sub aim is to describe the differences and discrepancies found during the adaptation process and compare the results with previous research. METHODS The translation and adaptation process of IPOS was conducted using recommended guidelines consisting of six phases and included cognitive interviews with patients (n = 11) and palliative care multidisciplinary team members (n = 8). The study was conducted in two major Estonian hospitals. RESULTS The Estonian IPOS demonstrated face and content validity, acceptance by patients and staff. As a result of expert group review and cognitive interviews with patients and staff, 9 semantic changes were implemented. CONCLUSIONS Patient and staff versions of the IPOS with a recall of 3 or 7 days were translated and culturally adapted for Estonia. The Estonian IPOS four versions are ready for use in Estonia.
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Affiliation(s)
- Merli Laissaar
- Tallinn University of Technology, Ehitajate tee 5, 19086, Tallinn, Estonia.
| | - Riina Hallik
- Tallinn University of Technology, Ehitajate tee 5, 19086, Tallinn, Estonia
| | - Pille Sillaste
- North Estonia Medical Centre Foundation, J. Sütiste tee 19, 13419, Tallinn, Estonia
| | - Ulvi Ragun
- Tartu University Hospital, L. Puusepa 1a, 50406, Tartu, Estonia
| | - Mari-Leen Pärn
- Tartu University Hospital, L. Puusepa 1a, 50406, Tartu, Estonia
| | - Kaiu Suija
- Tartu University Hospital, L. Puusepa 1a, 50406, Tartu, Estonia
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Masukawa K, Sato K, Shimizu M, Morita T, Miyashita M. Cancer Care Evaluation Scale (CCES): measuring the quality of the structure and process of cancer care from the perspective of patients with cancer. Jpn J Clin Oncol 2021; 51:92-99. [PMID: 32888002 DOI: 10.1093/jjco/hyaa165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 08/13/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To evaluate the quality of the structure and process of cancer care from the perspective of patients with cancer, we developed a Cancer Care Evaluation Scale. METHODS Two anonymous online surveys of patients with cancer in Japan were conducted using a convenience sample of 400 adult cancer outpatients. RESULTS In total, 162 patients participated in the online surveys. Factor analysis revealed that the Cancer Care Evaluation Scale had the following 12 domains: (i) relationship with physician, (ii) relationship with nurse, (iii) physical care by physician, (iv) physical care by nurse, (v) psycho-existential care, (vi) help with decision-making for patients, (vii) coordination and consistency, (viii) environment, (ix) cost, (x) availability, (xi) care for the side effects of cancer treatment by a physician, and (xii) care for the side effects of cancer treatment by a nurse. The Cancer Care Evaluation Scale was correlated with overall care satisfaction (r = 0.75), but not with the quality of life (r = 0.40). In regard to rest-retest reliability, most items showed an intraclass correlation coefficient of 0.7 or higher. CONCLUSION The validity and reliability of the Cancer Care Evaluation Scale were confirmed, suggesting that this tool is useful for evaluating the quality of cancer care from the perspective of patients with cancer.
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Affiliation(s)
- Kento Masukawa
- Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kazuki Sato
- Department of Nursing, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Megumi Shimizu
- Department of Gerontological and Home Healthcare Nursing, Course of Nursing, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tatsuya Morita
- Division of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - Mitsunori Miyashita
- Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan
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Hamano J, Mori M, Ozawa T, Sasaki J, Kawahara M, Nakamura A, Hashimoto K, Hisajima K, Koga T, Goto K, Fukumoto K, Morimoto Y, Goshima M, Sekimoto G, Baba M, Oya K, Matsunuma R, Azuma Y, Imai K, Morita T, Shinjo T. Comparison of the prevalence and associated factors of hyperactive delirium in advanced cancer patients between inpatient palliative care and palliative home care. Cancer Med 2020; 10:1166-1179. [PMID: 33314743 PMCID: PMC7897964 DOI: 10.1002/cam4.3661] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 11/20/2020] [Accepted: 11/23/2020] [Indexed: 11/12/2022] Open
Abstract
Background Hyperactive delirium is known to increase family distress and the burden on health care providers. We compared the prevalence and associated factors of agitated delirium in advanced cancer patients between inpatient palliative care and palliative home care on admission and at 3 days before death. Methods This was a post hoc exploratory analysis of two multicenter, prospective cohort studies of advanced cancer patients, which were performed at 23 palliative care units (PCUs) between Jan and Dec 2017, and on 45 palliative home care services between July and Dec 2017. Results In total, 2998 patients were enrolled and 2829 were analyzed in this study: 1883 patients in PCUs and 947 patients in palliative home care. The prevalence of agitated delirium between PCUs and palliative home care was 5.2% (95% CI: 4.2% ‐ 6.3%) vs. 1.4% (0.7% ‐ 2.3%) on admission (p < 0.001) and 7.6% (6.4% ‐ 8.9%) vs. 5.4% (4.0% ‐ 7.0%) 3 days before death (p < 0.001). However, multivariate logistic regression analysis revealed that the place of care was not significantly associated with the prevalence of agitated delirium at 3 days before death after adjusting for prognostic factors, physical risk factors, and symptoms. Conclusions There was no significant difference in the prevalence of agitated delirium at 3 days before death between inpatient palliative care and palliative home care after adjusting for the patient background, prognostic factors, symptoms, and treatment.
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Affiliation(s)
- Jun Hamano
- Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | | | | | - Jun Sasaki
- Yushoukai Medical Corporation, Tokyo, Japan
| | | | | | | | | | | | | | | | | | | | | | - Mika Baba
- Department of Palliative Medicine, Suita Tokushukai Hospital, Suita, Japan
| | - Kiyofumi Oya
- Department of Palliative and Supportive Care, Aso Iizuka Hospital, Fukuoka, Japan
| | - Ryo Matsunuma
- Department of Palliative Medicine, Kobe University Graduate school of Medicine, Hyogo, Japan
| | - Yukari Azuma
- Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Kengo Imai
- Seirei Hospice, Seirei Mikatahara General Hospital, Shizuoka, Japan
| | - Tatsuya Morita
- Department of Palliative and Supportive Care, Palliative Care Team, and Seirei Hospice, Seirei Mikatahara General Hospital, Shizuoka, Japan
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Antunes B, Ferreira PL. Validation and cultural adaptation of the Integrated Palliative care Outcome Scale (IPOS) for the Portuguese population. BMC Palliat Care 2020; 19:178. [PMID: 33234116 PMCID: PMC7687758 DOI: 10.1186/s12904-020-00685-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 11/15/2020] [Indexed: 11/10/2022] Open
Abstract
Background To culturally adapt and validate the Integrated Palliative care Outcome Scale to European Portuguese. Methods Multi-centred observational study with 2 assessment points. Data were collected in nine centres using consecutive sampling. All patients were screened for eligibility. Inclusion criteria: ≥18 years, mentally fit to give consent, diagnosed with an incurable, potentially life-threatening illness, read, write and understand Portuguese. Translation and back translation with independent native speakers blind to the original measure created a Portuguese version, which was culturally adapted using cognitive interviews. For psychometric testing, the COSMIN checklist was followed. Reliability and content validity were assessed for patient and staff versions. Construct and criterion validity were tested for patient version. Results 1703 individuals were screened between July 1st 2015 and February 2016, 135 (7.9%) were included. Mean age was 66.8 years (SD 12.7), 58 (43%) were female. Most patients (109; 80.7%) had a cancer diagnosis. Cronbach’s alpha showed good internal consistency, 0.657 for patient, 0.705 for staff versions. Intraclass correlation coefficient testing reproducibility revealed very good reliability, 0.794–0.950 for patient and 0.456–0.925 for staff versions. There was good content validity and significant results for construct validity. Physical symptoms were better detected by females. IPOS could discriminate: practical issues in different places of care, based on cancer diagnosis, physical and emotional symptoms based on life expectancy both for patient and professional dimensions, physical and emotional symptoms based on phase of illness, for professional dimensions, and physical symptoms from the patients’ viewpoint. Conclusions The Portuguese IPOS is a reliable and valid measure. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-020-00685-z.
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Affiliation(s)
- Bárbara Antunes
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
| | - Pedro Lopes Ferreira
- Centre for Health Studies and Research, University of Coimbra, Coimbra, Portugal.,Faculty of Economics, University of Coimbra, Coimbra, Portugal
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Mori M, Yamaguchi T, Matsuda Y, Suzuki K, Watanabe H, Matsunuma R, Kako J, Imai K, Usui Y, Matsumoto Y, Hui D, Currow D, Morita T. Unanswered questions and future direction in the management of terminal breathlessness in patients with cancer. ESMO Open 2020; 5 Suppl 1:e000603. [PMID: 33558034 PMCID: PMC7046422 DOI: 10.1136/esmoopen-2019-000603] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/01/2019] [Accepted: 02/04/2020] [Indexed: 12/14/2022] Open
Abstract
Breathlessness is among the most common and deteriorating symptoms in patients with advanced cancer, which may worsen towards the end of life. Breathlessness in patients with estimated life expectancy of weeks to days has unique clinical features: it tends to worsen rapidly over days to hours as death approaches often despite current symptom control measures. Breathlessness in patients during the last weeks to days of life can be called ‘terminal breathlessness’. While evidence has accumulated for the management of breathlessness in patients with cancer who are not dying, such evidence may not be fully applied to terminal breathlessness. Only a few studies have investigated the best practice of terminal breathlessness in patients with cancer. In this paper, we summarise the current evidence for the management of terminal breathlessness, and propose future directions of clinical research.
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Affiliation(s)
- Masanori Mori
- Palliative Care Team, Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka, Japan.
| | | | - Yoshinobu Matsuda
- Department of Psychosomatic Internal Medicine, Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Kozue Suzuki
- Department of Palliative Care, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
| | - Hiroaki Watanabe
- Department of Palliative Care, Komaki City Hospital, Komaki, Japan
| | - Ryo Matsunuma
- Department of Palliative Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Jun Kako
- Division of Nursing Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kengo Imai
- Seirei Hospice, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - Yuko Usui
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan
| | - Yoshihisa Matsumoto
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan
| | - David Hui
- Department of Palliative Care, Rehabilitation and Integrative Medicine, MD Anderson Cancer Center, Houston, Texas, USA
| | - David Currow
- Faculty of Health, University of Technology, Sydney, New South Wales, Australia
| | - Tatsuya Morita
- Division of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Japan
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Hiratsuka Y, Suh SY, Maeda I, Morita T, Mori M, Ito S, Nishi T, Hisanaga T, Iriyama T, Kaneishi K, Ikari T, Tagami K, Inoue A. Factors influencing spiritual well-being in terminally ill cancer inpatients in Japan. Support Care Cancer 2020; 29:2795-2802. [DOI: 10.1007/s00520-020-05802-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 09/24/2020] [Indexed: 11/25/2022]
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Shimosato M, Asai K, Yokomichi N, Nagano K, Sakane N. Diagnostic accuracy of patient-reported dry mouth as a predictor for oral dryness in terminally ill cancer patients. Support Care Cancer 2020; 29:2743-2748. [PMID: 32989524 DOI: 10.1007/s00520-020-05798-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 09/22/2020] [Indexed: 01/07/2023]
Abstract
PURPOSE The aim of the study was to determine the diagnostic accuracy of patient-reported dry mouth using an oral moisture-checking device in terminally ill cancer patients. METHODS The study was conducted following the STARD guidelines, and the participants were recruited prospectively from the Palliative Care Unit, Kyoto Medical Center, Japan, between 1 January 2017 and 30 November 2018. Patients reporting dry mouth were asked to rate oral dryness on a 5-point rating scale. The outcome was oral dryness at the lingual mucosa, measured using an oral moisture-checking device. Receiver operating characteristic (ROC) curves were plotted, and the sensitivity, specificity, positive and negative predictive values (PPV and NPV), positive and negative likelihood ratios (LR), and overall diagnostic accuracy were calculated. RESULTS Of 103 participants, the prevalence of oral dryness was 65.0%. ROC analysis indicated that patient-reported dry mouth was a poor predictor of oral dryness, with an area under the curve of 0.616 (95% confidence interval: 0.508-0.723), a sensitivity of 46.3%, a specificity of 75.8%, a PPV of 55.9%, an NPV of 68.1, a positive LR of 1.9, a negative LR of 0.7, and an overall diagnostic accuracy of 64.1%, with a cut-off value of 3 points. CONCLUSION In conclusion, patient-reported dry mouth is not a useful parameter for the assessment of oral dryness in terminally ill cancer patients.
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Affiliation(s)
- Maiko Shimosato
- Department of Oral and Maxillofacial Surgery, National Hospital Organization Kyoto Medical Center, 1-1, Fukakusa-Mukaihata, Fushimi-Ku, Kyoto, 612-8555, Japan.
| | - Keita Asai
- Department of Oral and Maxillofacial Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Naosuke Yokomichi
- Department of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - Keiji Nagano
- Division of Oral Biology, Health Sciences University of Hokkaido, Hokkaido, Japan
| | - Naoki Sakane
- Division of Preventive Medicine, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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Hocaoglu MB, Hepgul N, Tunnard I, Meltem E, Efe H, Ataoglu B, Baybar YL, Kınacıgil M, Elsharairi H, Higginson IJ. Towards patient-centred cancer care: cross-cultural validity and responsiveness of the Turkish Integrated Palliative care Outcome Scale. Health Qual Life Outcomes 2020; 18:312. [PMID: 32962717 PMCID: PMC7507708 DOI: 10.1186/s12955-020-01535-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 08/11/2020] [Indexed: 12/03/2022] Open
Abstract
Background A valid measure to describe the most important needs and concerns of people with life-threatening illnesses is missing in Cyprus. Our aim was to adapt and test the cross-cultural validity and responsiveness of the Integrated Palliative care Outcome Scale (IPOS) in a cohort of Turkish speaking cancer patients. Methods The IPOS (English) patient-reported measure was translated into Turkish following published guidelines including, 2 independent forward, 2 independent blind backward translations, expert panel review by 7 members and field testing with 11 cognitive interviews (5 patients and 6 specialists) and final approval of the copyright holder. Consecutive cancer patients (n = 234) seen by the community palliative care services were recruited from Help Those with Cancer Society (KHYD); of those 82 were followed-up. The instrument was administered by personal interview. Confirmatory Factor Analysis was used to validate the factor structure of Turkish IPOS. Internal consistency reliability of the subscales was evaluated by Cronbach’s alpha and Intraclass Correlation Coefficient respectively. Validity was assessed by calculating Pearson’s correlation coefficient (r) between Turkish IPOS scores and Turkish version of EQ-5D-3L - a validated generic measure of health status developed by the EuroQol Group. Results Turkish IPOS is conceptually and semantically equivalent to the English version and linguistically valid. The CFA was inconclusive for the three factor structure due to low sample size, as the SRMR and CFI tests only approached the defined minimums warranting further investigation. There were low levels of missing values, and no ceiling or floor effects. The Physical (α = 0.91) and the Social and Quality of Care Issues (α = 0.75) sub-scales showed good internal consistencies, however Emotional sub-scale showed poor internal consistency (α = 0.64). The reliability of the Physical (ICC = 0.51, 0.45–0.56 95% CI) and Social Quality of Care Issues (ICC = 0.50, 0.42–0.57 95% CI) were moderate. Poor internal consistency (α =0.64) and reliability (ICC = 0.31, 0.24–0.39, 95% CI) was obtained for Emotional Subscale. Construct validity was evidenced through significant correlations in the predicted directions and strength with EQ-5D. Turkish IPOS showed higher needs and concerns in participants at more advanced stages than those at earlier stages of cancer. The standardized response mean (SRM) of − 0.94 suggested large internal responsiveness to clinical change. Conclusion Turkish IPOS is a clear, relevant, acceptable measure and responsive to the needs and concerns of cancer patients, observing regional differences, it may have implications for use in other Turkish speaking communities. Future studies are needed to clarify the factor structure, assess its external responsiveness and to improve the properties of its Emotional subscale.
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Affiliation(s)
- Mevhibe B Hocaoglu
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK. .,Faculty of Medicine, Eastern Mediterranean University, Famagusta, North Cyprus, Cyprus.
| | - Nilay Hepgul
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - India Tunnard
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Emine Meltem
- Faculty of Medicine, Eastern Mediterranean University, Famagusta, North Cyprus, Cyprus
| | - Hande Efe
- Faculty of Medicine, Eastern Mediterranean University, Famagusta, North Cyprus, Cyprus
| | - Buse Ataoglu
- Faculty of Medicine, Eastern Mediterranean University, Famagusta, North Cyprus, Cyprus
| | - Yeliz Lerzan Baybar
- Faculty of Medicine, Eastern Mediterranean University, Famagusta, North Cyprus, Cyprus
| | - Merve Kınacıgil
- Faculty of Medicine, Eastern Mediterranean University, Famagusta, North Cyprus, Cyprus
| | - Husam Elsharairi
- Faculty of Medicine, Eastern Mediterranean University, Famagusta, North Cyprus, Cyprus
| | - Irene J Higginson
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
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Remawi BN, Gadoud A, Murphy IMJ, Preston N. Palliative care needs-assessment and measurement tools used in patients with heart failure: a systematic mixed-studies review with narrative synthesis. Heart Fail Rev 2020; 26:137-155. [PMID: 32748015 PMCID: PMC7769784 DOI: 10.1007/s10741-020-10011-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Patients with heart failure have comparable illness burden and palliative care needs to those with cancer. However, few of them are offered timely palliative care. One main barrier is the difficulty in identifying those who require palliative care. Several palliative care needs-assessment/measurement tools were used to help identify these patients and assess/measure their needs, but it is not known which one is the most appropriate for this population. This review aimed to identify the most appropriate palliative care needs-assessment/measurement tools for patients with heart failure. Cochrane Library, MEDLINE Complete, AMED, PsycINFO, CINAHL Complete, EMBASE, EThOS, websites of the identified tools, and references and citations of the included studies were searched from inception to 25 June 2020. Studies were included if they evaluated palliative care needs-assessment/measurement tools for heart failure populations in terms of development, psychometrics, or palliative care patient/needs identification. Twenty-seven papers were included regarding nineteen studies, most of which were quantitative and observational. Six tools were identified and compared according to their content and context of use, development, psychometrics, and clinical applications in identifying patients with palliative care needs. Despite limited evidence, the Needs Assessment Tool: Progressive Disease - Heart Failure (NAT:PD-HF) is the most appropriate palliative care needs-assessment tool for use in heart failure populations. It covers most of the patient needs and has the best psychometric properties and evidence of identification ability and appropriateness. Psychometric testing of the tools in patients with heart failure and evaluating the tools to identify those with palliative care needs require more investigation.
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Affiliation(s)
- Bader Nael Remawi
- Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster, LA1 4YG, UK.
| | - Amy Gadoud
- Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster, LA1 4YG, UK.,International Observatory on End of Life Care, Faculty of Health and Medicine, Lancaster University, Lancaster, LA1 4YG, UK
| | - Iain Malcolm James Murphy
- Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster, LA1 4YG, UK.,Trinity Hospice and Palliative Care Services, Low Moor Road, Blackpool, FY2 0BG, UK
| | - Nancy Preston
- International Observatory on End of Life Care, Faculty of Health and Medicine, Lancaster University, Lancaster, LA1 4YG, UK
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Amano K, Maeda I, Ishiki H, Miura T, Hatano Y, Oya K, Sakashita A, Ito S, Hiratsuka Y, Morita T, Mori M. Significance of fluid retention, body mass index, and weight loss in patients with advanced cancer. JCSM CLINICAL REPORTS 2020. [DOI: 10.1002/crt2.23] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
- Koji Amano
- Department of Palliative Medicine National Cancer Center Hospital 5‐1‐1 Tsukiji, Chuo‐ku Tokyo 104‐0045 Japan
- Department of Palliative and Supportive Medicine Graduate School of Medicine, Aichi Medical University 1‐1 Yazakokarimata Nagakute City Aich 480‐1195 Japan
| | - Isseki Maeda
- Department of Palliative Care Senri‐chuo Hospital Toyonaka Osaka Japan
| | - Hiroto Ishiki
- Department of Palliative Medicine National Cancer Center Hospital 5‐1‐1 Tsukiji, Chuo‐ku Tokyo 104‐0045 Japan
| | - Tomofumi Miura
- Department of Palliative Medicine National Cancer Center Hospital East Kashiwa Chiba Japan
| | - Yutaka Hatano
- Department of Palliative Care, Kyowakai Medical Corporation Daini Kyoritsu Hospital Kawanishi Hyogo Japan
| | - Kiyofumi Oya
- Department of Palliative and Transitional Care Aso Iizuka Hospital Iizuka Fukuoka Japan
| | - Akihiro Sakashita
- Department of Palliative Medicine Kobe University School of Medicine Kobe Hyogo Japan
| | - Satoko Ito
- Hospice The Japan Baptist Hospital Kyoto Kyoto Japan
| | - Yusuke Hiratsuka
- Department of Palliative Medicine Tohoku University School of Medicine Sendai Miyagi Japan
| | - Tatsuya Morita
- Palliative and Supportive Care Division Seirei Mikatahara General Hospital Hamamatsu Shizuoka Japan
| | - Masanori Mori
- Palliative Care Team Seirei Mikatahara General Hospital Hamamatsu Shizuoka Japan
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Amano K, Hatano Y, Matsuda Y, Maeda I, Ishiki H, Miura T, Imai K, Hori T, Matsuda Y, Funaki H, Suzuki K, Mori M, Morita T. C‐reactive protein, delirium, and other psychological symptoms among patients with advanced cancer. JCSM CLINICAL REPORTS 2020. [DOI: 10.1002/crt2.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
- Koji Amano
- Department of Palliative Medicine National Cancer Center Hospital 5‐1‐1 Tsukiji, Chuo‐ku Tokyo 1040045 Japan
| | | | - Yoshinobu Matsuda
- Department of Psychosomatic Internal Medicine National Hospital Organization Kinki‐Chuo Chest Medical Center Sakai City Japan
| | - Isseki Maeda
- Department of Palliative Care Senri‐chuo Hospital Toyonaka City Japan
| | - Hiroto Ishiki
- Department of Palliative Medicine National Cancer Center Hospital 5‐1‐1 Tsukiji, Chuo‐ku Tokyo 1040045 Japan
| | - Tomofumi Miura
- Department of Palliative Medicine National Cancer Center Hospital East Kashiwa City Japan
| | - Kengo Imai
- Seirei Hospice Seirei Mikatahara General Hospital Hamamatsu City Japan
| | - Tetsuo Hori
- Department of Clinical Oncology and Palliative Medicine Mitsubishi Kyoto Hospital Kyoto City Japan
| | - Yosuke Matsuda
- Palliative Care Department St. Luke's International Hospital Tokyo Japan
| | - Hiromi Funaki
- Department of Palliative Care Hiroshima Prefectural Hospital Hiroshima City Japan
| | - Kozue Suzuki
- Department of Palliative Care Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital Tokyo Japan
| | - Masanori Mori
- Palliative Care Team Seirei Mikatahara General Hospital Hamamatsu City Japan
| | - Tatsuya Morita
- Palliative and Supportive Care Division Seirei Mikatahara General Hospital Hamamatsu City Japan
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Anxiety, depression and psychosocial needs are the most frequent concerns reported by patients: preliminary results of a comparative explorative analysis of two hospital-based palliative care teams in Germany and Japan. J Neural Transm (Vienna) 2020; 127:1481-1489. [PMID: 32419058 PMCID: PMC7578135 DOI: 10.1007/s00702-020-02186-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 03/30/2020] [Indexed: 11/16/2022]
Abstract
In the partnership between the medical departments of Würzburg University, Germany, and Nagasaki University, Japan, palliative care is a relevant topic. The aim of the study was to perform a comparative analysis of the hospital-based palliative care teams in Würzburg (PCT-W) and Nagasaki (PCT-N). Survey of staff composition and retrospective analysis of PCT patient charts in both PCTs were conducted. Patients self-assessed their symptoms in PCT-W and in Radiation Oncology Würzburg (RO-W). The (negative) quality indicator ‘percentage of deceased hospitalised patients with PCT contact for less than 3 days before death’ (Earle in Int J Qual Health Care 17(6):505–509, 2005) was analysed. Both PCTs follow a multidisciplinary team approach. PCT-N saw 410 cancer patients versus 853 patients for PCT-W (22.8% non-cancer patients). The Eastern Cooperative Oncology Group Performance Status at first contact with PCT-N was 3 or 4 in 39.3% of patients versus 79.0% for PCT-W. PCT-N was engaged in co-management longer than PCT-W (mean 20.7 days, range 1–102 versus mean 4.9 days, range 1–48). The most frequent patient-reported psychological symptom was anxiety (family anxiety: 98.3% PCT-W and 88.7% RO-W, anxiety 97.9% PCT-W and 85.9% RO-W), followed by depression (98.2% PCT-W and 80.3% RO-W). In 14 of the 148 deceased patients, PCT-N contact was initiated less than 3 days before death (9.4%) versus 121 of the 729 deceased PCT-W patients (16.6%). Psychological needs are highly relevant in both Germany and Japan, with more than 85% anxiety and depression in patients in the Japanese IPOS validation study (Sakurai in Jpn J Clin Oncol 49(3):257–262, 2019). This should be taken into account when implementing PCTs.
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Mori M, Morita T, Imai K, Yokomichi N, Yamaguchi T, Masukawa K, Kizawa Y, Tsuneto S, Shima Y, Miyashita M. The Bereaved Families' Preferences for Individualized Goals of Care for Terminal Dyspnea: What Is an Acceptable Balance between Dyspnea Intensity and Communication Capacity? Palliat Med Rep 2020; 1:42-49. [PMID: 34223455 PMCID: PMC8241337 DOI: 10.1089/pmr.2020.0035] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2020] [Indexed: 12/22/2022] Open
Abstract
Background: Toward the individualized care of terminally ill patients with dyspnea (“terminal dyspnea”), it is essential to identify individualized goals of care (GOC) to achieve an acceptable balance between dyspnea intensity and communication capacity. Objective: To explore preferences for individualized GOC for terminal dyspnea, and factors associated with the preferences. Design: A nationwide cross-sectional survey. Setting/Subjects: In total, 1055 bereaved families of cancer patients admitted to 167 inpatient hospices in Japan. Measurements: Preferences for individualized GOC for terminal dyspnea to achieve an acceptable balance between dyspnea intensity and communication capacity, should individuals experience continuous moderate or severe/overwhelming dyspnea despite optimal palliative care, and perceptions about a good death. Results: Among 548 participants (response rate = 52%), we analyzed responses of 477 families whose loved one suffered dyspnea in the last week of life. In total, 167 (45%; 95% confidence interval [CI] = 40%–50%) and 272 (80%; 95% CI = 75%–84%) participants would prioritize dyspnea relief over communication capacity, should they continuously suffer moderate or severe/overwhelming dyspnea, respectively. In multivariate analyses, the determinants of the prioritization of dyspnea relief were perceiving physical comfort as important for a good death (odds ratio [OR] = 1.389; 95% CI = 1.062–1.818; p = 0.017) in moderate dyspnea, and perceiving physical comfort (OR = 2.505; 95% CI = 1.718–3.651; p < 0.001) and not perceiving mental awareness (OR = 0.695; 95% CI = 0.529–0.913; p = 0.009) as important in severe/overwhelming dyspnea. Conclusions: Preferences for individualized GOC for terminal dyspnea can vary among individuals and with different symptom intensity, and may be influenced by perceptions about a good death. Outcome measurements incorporating an acceptable balance between dyspnea intensity and communication capacity should be developed.
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Affiliation(s)
- Masanori Mori
- Division of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - Tatsuya Morita
- Division of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - Kengo Imai
- Seirei Hospice, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - Naosuke Yokomichi
- Division of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | | | - Kento Masukawa
- Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoshiyuki Kizawa
- Department of Palliative Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Satoru Tsuneto
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yasuo Shima
- Department of Palliative Medicine, Tsukuba Medical Center Hospital, Tsukuba, Ibaraki, Japan
| | - Mitsunori Miyashita
- Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan
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Vlckova K, Hoschlova E, Chroustova E, Loucka M. Psychometric properties of the Czech Integrated Palliative Outcome Scale: reliability and content validity analysis. BMC Palliat Care 2020; 19:39. [PMID: 32213172 PMCID: PMC7098098 DOI: 10.1186/s12904-020-00552-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 03/20/2020] [Indexed: 11/30/2022] Open
Abstract
Background Outcome measurement is an essential part of the evaluation of palliative care and the measurements need to be reliable, valid and adapted to the culture in which they are used. The Integrated Palliative Outcome Scale (IPOS) is a widely used tool for assessing personal-level outcomes in palliative care. The aim of this study was to provide Czech version of IPOS and assess its psychometric properties. Methods Patients receiving palliative care in hospice or hospitals completed the IPOS. The reliability of Czech IPOS was tested with Cronbach alpha (for internal consistency), the intraclass correlation coefficient for total IPOS score and weighted Kappa (for test-retest reliability of individual items). Factor analysis was used for elucidating the construct (Exploratory Factor Analysis). Convergent validity was tested with correlation analysis (Spearman correlation) in a part of the sample, who completed also the Edmonton Symptom Assessment System (ESAS) and the Palliative Performance Scale (PPS). Results The sample consisted of 140 patients (mean age 72; 90 women; 81% oncological disease). The Cronbach alpha was 0.789; intraclass correlation was 0.88. The correlations of IPOS with ESAS was R = 0.4 and PPS R = − 0.2. Exploratory factor analysis revealed a 2-factor solution on our data. The first factor covers emotional and information needs and the second factor covers physical symptoms. Conclusion Czech IPOS has very good reliability regarding both internal consistency and test-retest reliability. Together with an item analysis results, we can conclude that the Czech adaptation of the tool was successful. The convergent validity needs to be assessed on the larger sample and the proposed 2-factor internal structure of the questionnaire has to be confirmed by using CFA.
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Affiliation(s)
- Karolina Vlckova
- Center for Palliative Care, Dykova 15, 110 00, Prague, Czech Republic. .,First Faculty of Medicine, Department of Psychiatry, Charles University, Prague, Czech Republic.
| | - Eva Hoschlova
- Faculty of Arts, Department of Psychology, Charles University, Prague, Czech Republic
| | - Eva Chroustova
- Faculty of Arts, Department of Psychology, Charles University, Prague, Czech Republic
| | - Martin Loucka
- Center for Palliative Care, Dykova 15, 110 00, Prague, Czech Republic
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Kajiwara K, Kako J, Noto H. Letter in response to: "Determinants of self- and carer-rated quality of life and caregiver burden in Alzheimer disease". Int J Geriatr Psychiatry 2019; 34:1916. [PMID: 31407383 DOI: 10.1002/gps.5190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 08/06/2019] [Indexed: 11/11/2022]
Affiliation(s)
- Kohei Kajiwara
- Division of Nursing Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Jun Kako
- Division of Nursing Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiroko Noto
- Department of Health Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Sterie AC, Borasio GD, Bernard M. Validation of the French Version of the Integrated Palliative Care Outcome Scale. J Pain Symptom Manage 2019; 58:886-890.e5. [PMID: 31330287 DOI: 10.1016/j.jpainsymman.2019.07.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 07/10/2019] [Accepted: 07/12/2019] [Indexed: 11/28/2022]
Abstract
CONTEXT The Integrated Palliative care Outcome Scale (IPOS) is a widely used tool for assessing patient needs in palliative care. OBJECTIVES The aim of this study was to provide a validated version of the patient and staff IPOS for French-speaking Switzerland (IPOS-Fr) and assess its psychometric properties. METHODS The validation took place in 12 palliative care units and mobile teams. At baseline (T1) and three days later (T2), patients' general health status, palliative care needs (IPOS-Fr), and quality of life (McGill Quality of Life Scale-Revised) were assessed by patients and staff. RESULTS We included 173 patients (mean age: 68.8; 92 women; 85% oncologic disease). IPOS internal consistency was high for the total score (0.69 and 0.71). Staff-patient interrater agreement was good to moderate for 13 items (intraclass correlations >0.516). Results indicated strong correlations between IPOS-Fr and McGill Quality of Life Scale-Revised for the total score (-0.623 at T1) and the psychological domain (Item 11: -0.601 at T1; Item 13: -0.633 at T2). Regarding sensitivity to change, there was a significant difference between T1 and T2 for patients with an improved health condition (z = -2.326; P = 0.020). CONCLUSION IPOS-Fr has fair to good validity, especially with regard to interrater agreement and construct validity, is sensitive to positive change, and has good interpretability and acceptability for patients and staff. IPOS-Fr is not optimal in terms of internal consistency and structure when using subscale scores, except for the emotional subscale.
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Affiliation(s)
- Anca-Cristina Sterie
- Palliative and Supportive Care Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Gian Domenico Borasio
- Palliative and Supportive Care Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Mathieu Bernard
- Palliative and Supportive Care Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
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Sterie AC, Bernard M. Challenges in a six-phase process of questionnaire adaptation: findings from the French translation of the Integrated Palliative care Outcome Scale. BMC Palliat Care 2019; 18:38. [PMID: 30999910 PMCID: PMC6474036 DOI: 10.1186/s12904-019-0422-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 04/09/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Integrated Palliative care Outcome Scale (IPOS) was developed for evaluating essential outcomes for palliative care patients. Our objectives here are to describe the process of a six-phase cross-cultural adaptation of IPOS to French (IPOS-Fr), highlight the difficulties encountered and strategies to solve them, and discuss the implications that adaptation may have on the validity and reliability of a questionnaire. METHODS The adaptation of IPOS consisted of six phases: (i) literature review and interviews with target population; (ii) forward translation to French; (iii) backward translation to English; (iv) Expert Review; (v) cognitive interviews with target population; (vi) final review. RESULTS Translation, cognitive interviews, and exchanges with Expert Review members allowed to make changes adapted to the target language regarding item 5 ("vomiting") and 8 ("sore or dry mouth"), and to identify and address, in the original version of IPOS, syntactic inconsistencies in language used in items 11 to 15 and methodological problems with items 11 ("anxiety about treatment and illness"), 15 ("share … as much as you wanted") and 17 ("problems addressed"). The adaptation also indicated that patients might have difficulties in interpreting items 8 ("sore or dry mouth"), 10 ("poor mobility"), 11 ("anxiety"), 12 (projected feelings of family and friends), and 14 ("feeling at peace"), thus indicating the need of monitoring during the psychometric validation. CONCLUSIONS Following this process, IPOS-Fr has proved content and face validity. In our case, the adaptation allowed adjustments to be made to the questionnaire and, when this was not possible, highlighted potential biases and inconsistencies during the validation. The result relied on an intertwined and iterative process of seeking and reaching semantic, conceptual, and normative equivalence. We are now assessing the psychometrical properties of IPOS-Fr.
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Affiliation(s)
- Anca-Cristina Sterie
- Palliative and supportive care service, Lausanne University Hospital and University of Lausanne, Avenue Pierre-Decker 5, 1011, Lausanne, Switzerland.
| | - Mathieu Bernard
- Palliative and supportive care service, Lausanne University Hospital and University of Lausanne, Avenue Pierre-Decker 5, 1011, Lausanne, Switzerland
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