Care evaluation scale-patient version: measuring the quality of the structure and process of palliative care from the patient's perspective

J Pain Symptom Manage. 2014 Jul;48(1):110-8. doi: 10.1016/j.jpainsymman.2013.08.019. Epub 2014 Mar 27.


Context: Recently, greater emphasis has been placed on patient-reported outcomes. However, there are only a few measures to evaluate the quality of care from the patient's perspective.

Objectives: To report the development of a scale to measure the quality of the structure and process in palliative care from the patient's perspective and examine the reliability and validity of the scale.

Methods: A cross-sectional anonymous questionnaire was administered to cancer patients who were being treated on an oncology inpatient ward, who visited an oncology outpatient clinic at Saitama Medical University International Medical Center, or who were in an inpatient palliative unit in Japan between August 2007 and March 2008.

Results: A total of 405 cancer patients participated in the study. Factor analysis revealed that the Care Evaluation Scale-Patient version (CES-P) consisted of 23 items with eight subscales: physical care by physicians, physical care by nurses, psychoexistential care, help with decision making for patients, environment, cost, availability, and coordination/consistency. The total CES-P score was correlated with satisfaction (r = 0.63) but not with quality of life (r = 0.18). The Cronbach α coefficient of the total score was 0.97, and the intraclass correlation coefficient of the total score was 0.67. The CES-P total score was not significantly correlated with the self-reported Eastern Cooperative Oncology Group performance status (ρ = -0.05).

Conclusion: The CES-P has sufficient validity and reliability. In addition, this scale is independent of the general physical condition of the patient.

Keywords: Palliative care; hospice; neoplasms; quality of care; questionnaires.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Cross-Sectional Studies
  • Factor Analysis, Statistical
  • Female
  • Humans
  • Inpatients / psychology
  • Japan
  • Male
  • Middle Aged
  • Neoplasms / psychology*
  • Neoplasms / therapy*
  • Outpatients / psychology
  • Palliative Care / methods*
  • Patient Satisfaction
  • Quality Assurance, Health Care / methods*
  • Quality of Life
  • Reproducibility of Results
  • Surveys and Questionnaires*