Advancing the science of outcome measurement in paediatric palliative care

Richard Harding1, Lizzie Chambers2, Myra Bluebond-Langner3

  • 1Herbert Dunhill Chair, Professor of Palliative Care and Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute, Department of Palliative Care, Policy and Rehabilitation, King's College London.

Insights

A new person-centred outcome measure (PCOM) is needed for paediatric palliative care. This study identified key domains and implementation challenges for developing a PCOM to improve care for children and young people.

Area of Science:

  • Paediatric Palliative Care
  • Health Measurement
  • Outcome Measurement

Background:

  • Lack of validated person-centred outcome measures (PCOMs) hinders effective paediatric palliative care.
  • Current tools do not adequately capture the holistic needs of children and young people in palliative care.

Framework:

  • Expert group convened following COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidance.
  • Elicited views on essential domains and items for a PCOM.
  • Content analysis of expert group data informed tool development.

Implementation:

  • Key domains identified: symptoms, education, play, social interaction, parental support, sexual health, and sibling wellbeing.
  • Implementation challenges include meaningful engagement, perceived 'testing' of parents, unrealistic expectations, and proxy validity.
  • Need for clear guidance on administration, interpretation, data ownership, and access.

Implications:

  • This work addresses the initial step in PCOM development, focusing on face validity and acceptability.
  • Provides foundational information for the first phase of tool development.
  • Informs potential use and implementation strategies for a new PCOM in routine paediatric palliative care.
Abstract

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