Concordance in the Assessment of Effectiveness of Palliative Care between Patients and Palliative Care Nurses in Malaysia: A Study with the Palliative Care Outcome Scale

Gathering policymakers' perspectives as an essential step in planning and implementing palliative care services at a national level: an example from a resource-limited country

BACKGROUND

Despite increasing recognition of the role played by palliative care (PC) services, the priorities of policymakers in supporting PC remain unclear and have sometimes engendered controversy. There are few studies exploring policymakers' perspectives towards PC services, with most shedding light on obstacles to PC development. Furthermore, no study has explored policymakers' perspectives towards providing PC at the national level in resource-limited countries. This study provides a platform for providing PC as part of the Palestinian healthcare system (HCS) by exploring policymakers' perspectives on PC, an essential step to developing a PC programme.

METHODS

A descriptive qualitative study design was employed using semi-structured interviews. Participants were those identified as responsible for making executive and legislative decisions about health services (including PC) in the HCS. Data were analysed using qualitative content analysis.

RESULTS

Twelve decision and policymakers participated in the study. Four categories were generated from the content analysis: (1) the nature of current PC healthcare services, (2) the potential benefits of PC, (3) challenges to providing PC, and (4) considerations in providing PC. The current PC services provided to Palestinian patients with life-limiting illnesses and their families are not comprehensive, and are limited to symptom management. There is a Palestinian national strategic plan for developing PC; however, the development goals are not clearly defined, and the plan's capabilities are inadequate. Several challenges to the provision of PC were found to relate to issues of education and training, the allocation of funding, and the availability of medications.

CONCLUSIONS

Integrating PC into the Palestinian university curricula as a compulsory course and establishing higher degree programmes in PC to overcome the shortage of PC specialists is required. Developing policies aligned with national laws could help enhance health services to patients and their families and resolve several challenges. Cooperating with national and international institutions in seeking funding could boost PC development and medication availability.

Assessment of Psychosocial Distress among the Palliative Care Patients in Wardha District of Maharashtra

Aim:

Palliative Care Outcome Scale (POS) is one of the various tools, available for the evaluation of the effectiveness of palliative services, having 10item multidimensional questionnaire, designed to assess the physical, psychosocial, spiritual, and practical aspects of patients with various sufferings. In this study, we had assessed psychosocial distress among the patients of a palliative care clinic of a rural teaching hospital at Wardha district.

Methods:

In this cross-sectional study, a total of 118 patients attending the palliative care clinic under the medicine department were enrolled between July 2018 and March 2019. POS has 10 questions in Likert type of scale with a scoring of 0–4, 0 for no effect to 4 for overwhelming effect. Each question provides the information regarding how the patient feels in the past 3 days.

Results:

In the first assessment for anxiety about illness or treatment, 32% of the participants reply that they occasionally feel the anxiety, whereas the same reply has been given in follow-up assessment by 34% of the participants, with an average mean score of 1.59 and 1.31, respectively. Approximately 48% of the participants feel that their family or friends were occasionally anxious and worried for them in the first assessment of POS compared to follow-up assessment where the feeling has been changed with approximately 46% for not at all anxious or worried followed by 39% occasionally.

Conclusion:

Participants were satisfied and accepted the palliative care treatment provided by the team with frequent visits, and also, the level of improvement fastens.

The Palliative Care Outcome Scale: Turkish Validity and Reliability Study

Objective:

To examine the validity and reliability of the Turkish version of the Palliative Care Outcome Scale (POS).

Methods:

This methodological study consisted of 69 patients hospitalized in the palliative care (PC) service of three hospitals between June 2016 and August 2016, 69 carers who undertook continuously primary care of these patients, and 28 staff members working in the PC service and providing care to these patients. The data of the study were collected using the Personal Diagnosis Form, the POS. The scope, structure and criterion validity and internal consistency reliability of the scale were tested. Item analysis, Cronbach's alpha analysis, content validity ratio, confirmatory factor analysis for construct validity, criterion validity, patient validity, and intraclass correlation coefficient for the adaptation of outcomes of patient, carer, and staff groups were conducted.

Results:

The content validity ratio of the scale was found to be higher than 0.80 for patient, carer, and staff questionnaires. Item-total score correlation coefficients were determined between 0.27 and 0.72 for the items in the patient questionnaire, 0.33–0.67 for the carer questionnaire, and 0.34–0.72 for the staff questionnaire. The Cronbach's alpha reliability coefficients were determined as 0.64 for the patient questionnaire, 0.73 for the carer questionnaire, and 0.68 for the staff questionnaire.

Conclusions:

The Turkish version of the POS was determined to be a valid and reliable tool to be used for assessing the needs of PC patients in three dimensions in terms of the perspectives of patient, carer, and staff.