A brief, patient- and proxy-reported outcome measure in advanced illness: Validity, reliability and responsiveness of the Integrated Palliative care Outcome Scale (IPOS)

Murtagh, Fliss E.M.; Ramsenthaler, Christina; Firth, Alice; Groeneveld, Esther I.; Lovell, Natasha; Simon, Steffen T.; Denzel, Johannes; Guo, Ping; Bernhardt, Florian; Schildmann, Eva; van Oorschot, Birgitt; Hodiamont, Farina; Streitwieser, Sabine; Higginson, Irene J.; Bausewein, Claudia

Abstract

Background:
Few measures capture the complex symptoms and concerns of those receiving palliative care.

Aim:
To validate the Integrated Palliative care Outcome Scale, a measure underpinned by extensive psychometric development, by evaluating its validity, reliability and responsiveness to change.

Design:
Concurrent, cross-cultural validation study of the Integrated Palliative care Outcome Scale – both (1) patient self-report and (2) staff proxy-report versions. We tested construct validity (factor analysis, known-group comparisons, and correlational analysis), reliability (internal consistency, agreement, and test–retest reliability), and responsiveness (through longitudinal evaluation of change).

Setting/participants:
In all, 376 adults receiving palliative care, and 161 clinicians, from a range of settings in the United Kingdom and Germany

Results:
We confirm a three-factor structure (Physical Symptoms, Emotional Symptoms and Communication/Practical Issues). Integrated Palliative care Outcome Scale shows strong ability to distinguish between clinically relevant groups; total Integrated Palliative care Outcome Scale and Integrated Palliative care Outcome Scale subscale scores were higher – reflecting more problems – in those patients with ‘unstable’ or ‘deteriorating’ versus ‘stable’ Phase of Illness (F = 15.1, p  0.60). Longitudinal validity in form of responsiveness to change is good.

Conclusion:
The Integrated Palliative care Outcome Scale is a valid and reliable outcome measure, both in patient self-report and staff proxy-report versions. It can assess and monitor symptoms and concerns in advanced illness, determine the impact of healthcare interventions, and demonstrate quality of care. This represents a major step forward internationally for palliative care outcome measurement.

Citation

Murtagh, F. E., Ramsenthaler, C., Firth, A., Groeneveld, E. I., Lovell, N., Simon, S. T., Denzel, J., Guo, P., Bernhardt, F., Schildmann, E., van Oorschot, B., Hodiamont, F., Streitwieser, S., Higginson, I. J., & Bausewein, C. (in press). A brief, patient- and proxy-reported outcome measure in advanced illness: Validity, reliability and responsiveness of the Integrated Palliative care Outcome Scale (IPOS). Palliative medicine, 026921631985426. https://doi.org/10.1177/0269216319854264

• Journal Article Type: Article
• Acceptance Date: May 10, 2019
• Online Publication Date: Jun 12, 2019
• Deposit Date: Jun 14, 2019
• Publicly Available Date: Jun 14, 2019
• Journal: Palliative Medicine
• Print ISSN: 0269-2163
• Publisher: SAGE Publications
• Peer Reviewed: Peer Reviewed
• Pages: 026921631985426
• DOI: https://doi.org/10.1177/0269216319854264
• Keywords: Anesthesiology and Pain Medicine; General Medicine
• Public URL: https://hull-repository.worktribe.com/output/1990551
• Publisher URL: https://journals.sagepub.com/doi/10.1177/0269216319854264
• Contract Date: Jun 14, 2019