Reliability and validity of the Thai translation (Thai PPS Adult Suandok) of the Palliative Performance Scale (PPSv2)

the Thai PPS Adult Suandok tool was translated from the Palliative Performance Scale (PPSv2) and had been used in Chiang Mai, Thailand for several years.

to test the reliability and validity of the Thai translation of PPSv2.

a set of 22 palliative cases were used to determine a PPS score on Time-1, and repeated two weeks later as Time-2. A survey questionnaire was also completed for qualitative analysis.

a total of 70 nurses and physicians from Maharaj Nakorn Hospital in Chiang Mai participated.

The Time-1 intraclass correlation coefficient (ICC) for absolute agreement is 0.911 (95% CI 0.86-0.96) and for consistency is 0.92 (95% CI 0.87-0.96). The Time-2 ICC for agreement is 0.905 (95% CI 0.85-0.95) and for consistency is 0.912 (95% CI 0.86-0.96). These findings indicate good agreement among participants and also were somewhat higher in the Time-2 re-test phase. Cohen's kappa score is 0.55, demonstrating a moderate agreement. Thematic analysis from the surveys showed that 91% felt PPS to be a valuable clinical tool overall, with it being 'very useful' or 'useful' in several areas, including care planning (78% and 20%), disease monitoring (69% and 27%) and prognostication (61% and 31%), respectively. Some respondents noted difficulty in determining appropriate scores in paraplegic patients or those with feeding tubes, while others found the instructions long or difficult.

the Thai PPS Adult Suandok translated tool has good inter- and intra-rater reliability and can be used regularly for clinical care.