Measurement Properties of ID-PALL, A New Instrument for the Identification of Patients With General and Specialized Palliative Care Needs

Fabienne Teike Lüthi; Mathieu Bernard; Katia Vanderlinden; Pierluigi Ballabeni; Claudia Gamondi; Anne-Sylvie Ramelet; Gian Domenico Borasio

doi:10.1016/j.jpainsymman.2021.03.010

Measurement Properties of ID-PALL, A New Instrument for the Identification of Patients With General and Specialized Palliative Care Needs

J Pain Symptom Manage. 2021 Sep;62(3):e75-e84. doi: 10.1016/j.jpainsymman.2021.03.010. Epub 2021 Mar 26.

Authors

Fabienne Teike Lüthi¹, Mathieu Bernard², Katia Vanderlinden², Pierluigi Ballabeni³, Claudia Gamondi⁴, Anne-Sylvie Ramelet⁵, Gian Domenico Borasio²

Affiliations

¹ Palliative and Supportive Care Service, Lausanne University Hospital and University of Lausanne (F.T.L., M.B., K.V., C.G., G.D.B.), Lausanne, Switzerland; Institute of Higher Education and Research in Healthcare, University of Lausanne and Lausanne University Hospital (F.T.L., P.B., A.S.R.), Lausanne, Switzerland. Electronic address: fabienne.teike-luethi@chuv.ch.
² Palliative and Supportive Care Service, Lausanne University Hospital and University of Lausanne (F.T.L., M.B., K.V., C.G., G.D.B.), Lausanne, Switzerland.
³ Institute of Higher Education and Research in Healthcare, University of Lausanne and Lausanne University Hospital (F.T.L., P.B., A.S.R.), Lausanne, Switzerland; Centre for Primary Care and Public Health (Unisanté), University of Lausanne (P.B.), Lausanne, Switzerland.
⁴ Palliative and Supportive Care Service, Lausanne University Hospital and University of Lausanne (F.T.L., M.B., K.V., C.G., G.D.B.), Lausanne, Switzerland; Palliative and Supportive Care Service, Oncology Institute of Southern Switzerland (C.G.), Ticino, Switzerland.
⁵ Institute of Higher Education and Research in Healthcare, University of Lausanne and Lausanne University Hospital (F.T.L., P.B., A.S.R.), Lausanne, Switzerland.

PMID: 33781917
DOI: 10.1016/j.jpainsymman.2021.03.010

Abstract

Context: To improve access to palliative care, identification of patients in need of general or specialized palliative care is necessary. To our knowledge, no available identification instrument makes this distinction. ID-PALL is a screening instrument developed to differentiate between these patient groups.

Objective: To assess the structural and criterion validity and the inter-rater agreement of ID-PALL.

Methods: In this multicenter, prospective, cross-sectional study, nurses and physicians assessed medical patients hospitalized for 2 to 5 days in two tertiary hospitals in Switzerland using ID-PALL. For the criterion validity, these assessments were compared to a clinical gold standard evaluation performed by palliative care specialists. Structural validity, internal consistency and inter-rater agreement were assessed.

Results: 2232 patients were assessed between January and December 2018, 97% by nurses and 50% by physicians. The variances for ID-PALL G and S are explained by two factors, the first one explaining most of the variance in both cases. For ID-PALL G, sensitivity ranged between 0.80 and 0.87 and specificity between 0.56 and 0.59. ID-PALL S sensitivity ranged between 0.82 and 0.94, and specificity between 0.35 and 0.64. A cut-off value of 1 delivered the optimal values for patient identification. Cronbach's alpha was 0.78 for ID-PALL G and 0.67 for ID-PALL S. The agreement rate between nurses and physicians was 71.5% for ID-PALL G and 64.6% for ID-PALL S.

Conclusion: ID-PALL is a promising screening instrument allowing the early identification of patients in need of general or specialized palliative care. It can be used by nurses and physicians without a specialized palliative care training. Further testing of the finalized clinical version appears warranted.

Keywords: ID-PALL; Nurses; Palliative medicine; Physicians; Psychometrics; Sensitivity and specificity.

Publication types

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

MeSH terms

Cross-Sectional Studies
Humans
Palliative Care*
Prospective Studies
Psychometrics
Reproducibility of Results
Surveys and Questionnaires