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BMC Palliative Care
Published in: BMC Palliative Care 1/2024

Open Access 01-12-2024 | Research

Cross-cultural adaptation and psychometric validation of point-of-care outcome assessment tools in Chinese palliative care clinical practice

Authors: Yunyun Dai, Claire E Johnson, Jinfeng Ding, Yongyi Chen, Alanna Connolly, Lianjun Wang, Barbara A Daveson

Published in: BMC Palliative Care | Issue 1/2024

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Abstract

Background

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.

Methods

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.

Results

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).

Conclusions

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.
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Literature
1.
Currow DC, Allingham S, Yates P, Johnson C, Clark K, Eagar K. Improving national hospice/palliative care service symptom outcomes systematically through point-of-care data collection, structured feedback and benchmarking. Support Care Cancer. 2015;23:307–15.CrossRefPubMed
2.
Spencer A, Horridge K, Downs D. Empowering clinical data collection at the point of care. Arch Dis Child. 2015;100(9):815–7.CrossRefPubMed
3.
Bain CA, Bucknall T, Weir-Phyland J. A clinical quality feedback loop supported by mobile point-of-care (POC) data collection. 2013.
4.
Richardson A, Medina J, Brown V, Sitzia J. Patients’ needs assessment in cancer care: a review of assessment tools. Support Care Cancer. 2007;15(10):1125–44.CrossRefPubMed
5.
Currow DC, Eagar K, Aoun S, Fildes D, Yates P, Kristjanson LJ. Is it feasible and desirable to collect voluntarily quality and outcome data nationally in palliative oncology care? J Clin Oncol. 2008;26(23):3853–9.CrossRefPubMed
6.
Yang W, Wu B, Tan SY, Li B, Lou VW, Chen Z, et al. Understanding health and social challenges for aging and long-term care in China. Res Aging. 2021;43(3–4):127–35.CrossRefPubMed
7.
Daveson B, Blanchard M, Clapham S, Draper K, Connolly A, Currow D. Population-level, patient-reported outcomes: a case study regarding a public health intervention that involves patients with life-limiting illnesses. Front Public Health. 2023;11.
8.
9.
Daveson BA, Allingham SF, Clapham S, Johnson CE, Currow DC, Yates P, et al. The PCOC Symptom Assessment Scale (SAS): a valid measure for daily use at point of care and in palliative care programs. PLoS ONE. 2021;16(3):e0247250.CrossRefPubMedPubMedCentral
10.
Masso M, Allingham SF, Johnson CE, Pidgeon T, Yates P, Currow D, et al. Palliative Care Problem Severity score: reliability and acceptability in a national study. Palliat Med. 2016;30(5):479–85.CrossRefPubMed
11.
Masso M, Allingham SF, Banfield M, Johnson CE, Pidgeon T, Yates P, et al. Palliative care phase: inter-rater reliability and acceptability in a national study. Palliat Med. 2015;29(1):22–30.CrossRefPubMed
12.
Abernethy AP, Shelby-James T, Fazekas BS, Woods D, Currow DC. The Australia-modified Karnofsky Performance Status (AKPS) scale: a revised scale for contemporary palliative care clinical practice [ISRCTN81117481]. BMC Palliat care. 2005;4(1):1–12.CrossRef
13.
Fries BE, Schneider DP, Foley WJ, Gavazzi M, Burke R, Cornelius E. Refining a case-mix measure for nursing homes: Resource Utilization Groups (RUG-III). Medical care. 1994:668 – 85.
14.
Eagar K, Watters P, Currow DC, Aoun SM, Yates P. The Australian Palliative Care outcomes collaboration (PCOC)–measuring the quality and outcomes of palliative care on a routine basis. Aust Health Rev. 2010;34(2):186–92.CrossRefPubMed
15.
Brislin RW. Back-translation for Cross-cultural Research. J Cross-Cult Psychol. 1970;1(3):185–216.CrossRef
16.
Pohontsch N, Meyer T. Cognitive interviewing - a tool to develop and validate questionnaires. Rehabilitation (Stuttg). 2015;54(1):53–9.PubMed
17.
Willis GB, Artino AR. Jr. What do our respondents think we’re asking? Using Cognitive interviewing to improve medical education surveys. J Grad Med Educ. 2013;5(3):353–6.CrossRefPubMedPubMedCentral
18.
Aoun SM, Monterosso L, Kristjanson LJ, McConigley R. Measuring symptom distress in palliative care: psychometric properties of the Symptom Assessment Scale (SAS). J Palliat Med. 2011;14(3):315–21.CrossRefPubMed
19.
Bruera E, Kuehn N, Miller MJ, Selmser P, Macmillan K. The Edmonton Symptom Assessment System (ESAS): a simple method for the assessment of palliative care patients. J Palliat Care. 1991;7(2):6–9.CrossRefPubMed
20.
Dong Y, Chen H, Zheng Y, Guo Y, Kwon JH, Liu E, et al. Psychometric validation of the Edmonton symptom assessment system in Chinese patients. J Pain Symptom Manag. 2015;50(5):712–7. e2.CrossRef
21.
Flack VF, Afifi A, Lachenbruch P, Schouten H. Sample size determinations for the two rater kappa statistic. Psychometrika. 1988.
22.
IBM SPSS Statistics for Windows. Version 25.0. [Internet]. Armonk, NY: IBM Corp; 2017.
23.
Sprangers MA, Aaronson NK. The role of health care providers and significant others in evaluating the quality of life of patients with chronic disease: a review. J Clin Epidemiol. 1992;45(7):743–60.CrossRefPubMed
24.
Robertson AO, Tadić V, Horvat-Gitsels LA, Cortina-Borja M, Rahi JS. Differences in self-rated Versus parent Proxy–Rated Vision-Related Quality of Life and Functional Vision of visually impaired children. Am J Ophthalmol. 2021;230:167–77.CrossRefPubMed
25.
Asuero AG, Sayago A, González A. The correlation coefficient: an overview. Crit Rev Anal Chem. 2006;36(1):41–59.CrossRef
26.
Streiner DL. Starting at the beginning: an introduction to coefficient alpha and internal consistency. J Pers Assess. 2003;80(1):99–103.CrossRefPubMed
27.
Landis JR, Koch GG. The measurement of observer agreement for categorical data. biometrics. 1977:159 – 74.
28.
29.
Peter M, Fayers DM. Scores and measurements: validity, reliability, sensitivity. Oxford, UK: John Wiley & Sons, Ltd; 2015. pp. 89–124.
30.
Hadlandsmyth K, Sabic E, Zimmerman MB, Sluka KA, Herr KA, Clark CR, et al. Relationships among pain intensity, pain-related distress, and psychological distress in pre-surgical total knee arthroplasty patients: a secondary analysis. Psychol Health Med. 2017;22(5):552–63.CrossRefPubMed
31.
Feinstein AR, Cicchetti DV. High agreement but low kappa: I. The problems of two paradoxes. J Clin Epidemiol. 1990;43(6):543–9.CrossRefPubMed
Metadata
Title
Cross-cultural adaptation and psychometric validation of point-of-care outcome assessment tools in Chinese palliative care clinical practice
Authors
Yunyun Dai
Claire E Johnson
Jinfeng Ding
Yongyi Chen
Alanna Connolly
Lianjun Wang
Barbara A Daveson
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Palliative Care / Issue 1/2024
Electronic ISSN: 1472-684X
DOI
https://doi.org/10.1186/s12904-024-01395-6

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