Initial assessment of patients without cognitive failure admitted to palliative care: a validation study

Many assessment tools have been developed for palliative care and there are a number of differences between them. Therefore, we felt that there was room for improvement.

In a previous study, the relevant items were selected by a Delphi process with international experts in palliative care. A 5-point verbal scale was added to the items selected and adapted to the different kind of items.

The study included 123 patients, 63 (51%) were female and the median age was 64 (37 to 88). A four-factor structure was found through the principal components analysis, explaining 60.1% of the total variance. The scale presented good reliability, with a Cronbach's alpha of 0.72. It was hypothesized as a validity of construct that as the total symptom burden increased, survival time would decrease. This hypothesis was confirmed by the statistical analysis performed. A hazard ratio of 1.016 (P=0.019) was obtained in the Cox regression model including the final score as an explanatory variable of survival time, which means that for each increment of 1% in the total score, there was an increased risk of death of 1.6%.

This tool is in accordance with the recommended characteristics that an assessment tool should have. It is simple to administer and easy to explain, complete and analyze. It is also a valid tool.