A reliability and validity study of the Palliative Performance Scale

Ho, Francis; Lau, Francis; Downing, Michael; Lesperance, Mary

doi:10.1186/1472-684x-7-10

Cited by 152 publications

(136 citation statements)

References 11 publications

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“…Prospective data was also obtained to develop standardised evaluation measures for the individual sites: These scores were used to give an indication of symptom burden, physical function and expected survival time upon referral to the service. Palliative Performance Scale (PPS) is a modification of the Karnofsky Performance Scale (KPS), developed in 1996 and validated as a reliable tool [28]. It is designed specifically for measurement of physical status in palliative care.…”

Section: Quantitative Datamentioning

confidence: 99%

Impact of the Macmillan specialist Care at Home service: a mixed methods evaluation across six sites

et al. 2018

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Background: The Midhurst Macmillan Specialist Palliative Care at Home Service was founded in 2006 to improve community-based palliative care provision. Principal components include; early referral; home-based clinical interventions; close partnership working; and flexible teamwork. Following a successful introduction, the model was implemented in six further sites across England. This article reports a mixed methods evaluation of the implementation across these 'Innovation Centres'. The evaluation aimed to assess the process and impact on staff, patients and carers of providing Macmillan Specialist Care at Home services across the six sites. Methods: The study was set within a Realist Evaluation framework and used a longitudinal, mixed methods research design. Data collection over 15 months (2014)(2015)(2016) Qualitative data methods included: focus groups with project team and staff (n = 32 groups with n = 190 participants), and, volunteers (n = 6 groups with n = 32 participants). Quantitative data were analysed using SPPS Vs. 21 and qualitative data was examined via thematic analysis. Results: Comparison of findings across the six sites revealed the impact of their unique configurations on outcomes, compounded by variations in stage and mode of implementation. PPS, PPI and IPOS data revealed disparity in early referral criteria, complicated by contrasting interpretations of palliative care. The qualitative analysis, CSNAT and VOICES-SF data confirmed the value of the Macmillan model of care but uptake of specialist home-based clinical interventions was limited. The Macmillan brand engendered patient and carer confidence, bringing added value to existing services. Significant findings included better co-ordination of palliative care through project management and a single referral point and multi-disciplinary teamwork including leadership from consultants in palliative medicine, the role of health care assistants in rapid referral, and volunteer support. Conclusions: Macmillan Specialist Care at Home increases patient choice about place of death and enhances the quality of end of life experience. Clarification of key components is advocated to aid consistency of implementation across different sites and support future evaluative work.

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Section: Quantitative Datamentioning

confidence: 99%

Impact of the Macmillan specialist Care at Home service: a mixed methods evaluation across six sites

et al. 2018

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“…20 It is 1 of 11 possible scores (0, 10, 20, ..., 100%, 100%=best). It describes a patient's level of ambulation, activity level, evidence of disease, ability to perform self-care, intake, and level of consciousness.…”

Section: Outcome Definitionsmentioning

confidence: 99%

Symptom burden and performance status in a population‐based cohort of ambulatory cancer patients

Barbera

Seow

Howell

et al. 2010

Cancer

197

128

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BACKGROUND. For ambulatory cancer patients, Ontario has standardized symptom and performance status assessment population-wide, using the Edmonton Symptom Assessment System (ESAS) and Palliative Performance Scale (PPS). In a broad cross-section of cancer outpatients, the authors describe the ESAS and PPS scores and their relation to patient characteristics. METHODS. This is a descriptive study using administrative healthcare data. RESULTS. The cohort included 45,118 and 23,802 patients' first ESAS and PPS, respectively. Fatigue was most prevalent (75%), and nausea least prevalent (25%) in the cohort. More than half of patients reported pain or shortness of breath; about half of those reported moderate to severe scores. Seventy-eight percent had stable performance status scores. On multivariate analysis, worse ESAS outcomes were consistently seen for women, those with comorbidity, and those with shorter survivals from assessment. Lung cancer patients had the worst burden of symptoms. CONCLUSIONS. This is the first study to report ESAS and PPS scores in a large, geographically based cohort with a full scope of cancer diagnoses, including patients seen earlier in the cancer trajectory (ie, treated for cure). In this ambulatory cancer population, the high prevalence of numerous symptoms parallels those reported in palliative populations and represents a target for improved clinical care. Differences in outcomes for subgroups require further investigation. This research sets the groundwork for future research on patient and provider outcomes using linked administrative healthcare data. Cancer 2010;116:5767-76.

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“…Many objective and subjective prognostic factors were examined to evaluate prognostic value to the patients. To date, patient's performance status, diverse physical symptoms, biochemical markers, and other various subjective parameters were known as significant prognostic factors (1)(2)(3)(4)(5)(6)(7)(8)(9). Such prognostic factors provide more accurate clinical information about patients to their physicians.…”

Section: Introductionmentioning

confidence: 99%

Change in Palliative Performance Scale (PPS) Predicts Survival in Patients with Terminal Cancer

Lee

Seo

et al. 2017

Korean J Hosp Palliat Care

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Purpose:The Palliative Performance Scale (PPS) is a widely used prognostic tool in patients with advanced cancer. This study examines the association between changes in PPS score and survival in patients with advanced cancer. Methods: We identified a cohort of 606 inpatients who died at a Korean university hospital's hospice/palliative care center. For each patient, the PPS score was measured twice according to a standard procedure: 1) upon admission, and 2) three days after admission (D3). "Change on D3" was defined as a difference between initial PPS and PPS on D3. We used a Cox regression modeling approach to explore the association between this score change and survival. Results: The changes in scores were associated with survival. A score change of ＞30% yielded a hazard ratio for death of 2.66 (95% CI 2.19∼3.22), compared to a score change of ≤30%. PPS of ≤30 on D3 also independently predicted survival, with a hazard ratio of 1.67 (95% CI 1.38∼2.02) compared to PPS of ＞30. Conclusion: A change of over 30% in PPS appears to predict survival in hospitalized patients with terminal cancer, even after adjustment for confounders. Changes in PPS may be a more sensitive indicator of impending death than a single PPS measured on the day of admission in terminal cancer patients. Further prospective study is needed to examine this important finding in other populations.

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A reliability and validity study of the Palliative Performance Scale

Cited by 152 publications

References 11 publications

Impact of the Macmillan specialist Care at Home service: a mixed methods evaluation across six sites

Impact of the Macmillan specialist Care at Home service: a mixed methods evaluation across six sites

Symptom burden and performance status in a population‐based cohort of ambulatory cancer patients

Change in Palliative Performance Scale (PPS) Predicts Survival in Patients with Terminal Cancer

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