Palliative Performance Scale (PPS) scores have shown potential for prognosticating survival in Caucasian samples, but have not been studied for prognostic value in cancer patients from minority groups. Using data obtained from a retrospective chart audit of 492 cancer patients admitted over an 18-month period to a minority-serving home-based hospice and palliative care program, we examined the relationship between PPS scores and length of survival (survival days). Patients with PPS scores of 10% to 30% had fewer survival days than those with scores of 40% and those with scores of 50% to 100% (median = 6, 19, and 34 days, respectively; F = 25.02, P < 0.001). A PPS score of 40% serves as a reliable inclusion criterion for a study requiring two weeks for completion, while 50% to 100% is required for a three-week study. Findings from a predominantly minority sample are similar to those from predominantly Caucasian samples. KeywordsPalliative Performance Scale; prognostication; survival; minorities; hospice; palliative carePrognosticating the length of time that a person with terminal cancer will survive is important for implementing feasible research studies that will have generalizable findings and contribute to effective end-of-life care (1,2). Unfortunately, predicting survival is not easy (3), even after admission to hospice or palliative care programs. Palliative Performance Scale (PPS) scores have shown potential for prognosticating survival in predominately Caucasian samples, but have not been studied for prognostic value in cancer patients from racial and ethnic minority groups. From an instrument validity perspective, it is important to establish that the PPS prognosticates survival in racial and ethnic minority groups as well as it does for racial majority groups, but previous research studies included few cancer patients from racial and ethnic minority groups.Address correspondence to: Diana J. Wilkie, PhD, RN, FAAN, Department of Medical-Surgical Nursing (MC 802), College of Nursing, University of Illinois at Chicago, 845 South Damen Avenue, Room 660, Chicago, IL 60612-7350, USA, E-mail: E-mail: diwilkie@uic.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Although many cancer patients die soon after enrollment in hospice, the number of days they survive (survival days) varies greatly. Using Medicare data from 1990 with a sample of 6,451 patients, of whom 92% were Caucasian and 80% were diagnosed with cancer, investigators (4) found that the median survival after hospice enrollment was 36 days but that 16% of patients died within seven days and 15% liv...

This interdisciplinary PC training model addressed local workforce issues by increasing the number of clinicians capable of providing PC. Unique features include individualized longitudinal mentoring, interdisciplinary education, on-site project implementation, and local network building. Future research will address the impact of the addition of social work and chaplain trainees to the program.

Outpatient ACP is feasible early in the care of patients with stage IV cancer through systematic improvement in workflow and motivated providers. Education and infrastructure were pivotal to routine development of advance care plans.

Hospice volunteering during preclinical years may provide valuable experiential training for MS-1s in caring for seriously ill patients and their families by fostering personal reflection and empathic skills, thereby providing a foundation for future patient encounters during clinical training.

A multimodality curriculum including self-directed learning, lectures, and practice with simulated and actual outpatients with active reflection and feedback is effective in improving resident comfort level and formal training in ACP. Further research is needed to understand whether these interventions will translate into an increased frequency of discussions with patients about ACP after residency training.