Evaluation des spanischen Diagnostik-Tools für die Komplexität in der Palliativmedizin, IDC-Pal, durch Hausärzte in Deutschland: Eine Pilotstudie

Comino, Maria Rosa Salvador; García, Víctor Regife; López, Maria Auxiliadora Fernández; Feddersen, Berend; Roselló, María Luisa Martin; Sanftenberg, Linda; Schelling, Jörg

doi:10.1055/s-0043-104215

Cited by 8 publications

(10 citation statements)

References 13 publications

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“…Different models of classification of the complexity of palliative needs have been developed (Hex-Com, Perroca-Scale, AN-SNAP, Hui-Major-Criteria, IDC-Pal, PALCOM) [ 35 , 35 , 37 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 ]. Most of these tools are based on the consensus of experts who identified the characteristics considered to be of greatest complexity and their posterior validation in cross-sectional or Delphi studies.…”

Section: Discussionmentioning

confidence: 99%

Validation Study of the PALCOM Scale of Complexity of Palliative Care Needs: A Cohort Study in Advanced Cancer Patients

Viladot,

Gallardo-Martínez,

Hernandez-Rodríguez

et al. 2023

Cancers

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Background: In a patient-centred model of care, referral to early palliative care (EPC) depends on both the prognosis and the complexity of care needs. The PALCOM scale is a 5-domain multidimensional assessment tool developed to identify the level of complexity of palliative care needs of cancer patients. The aim of this study was to validate the PALCOM scale. Patient and methods: We conducted a prospective cohort study of cancer patients to compare the PALCOM scale and expert empirical assessment (EA) of the complexity of palliative care needs. The EA had to categorise patients according to their complexity, considering that medium to high levels required priority attention from specialist EPC teams, while those with low levels could be managed by non-specialist teams. Systematically collected multidimensional variables were recorded in an electronic report form and stratified by level of complexity and rating system (PALCOM scale versus EA). The correlation rank (Kendall’s tau test) and accuracy test (F1-score) between the two rating systems were analysed. ROC curve analysis was used to determine the predictive power of the PALCOM scale. Results: A total of 283 advanced cancer patients were included. There were no significant differences in the frequency of the levels of complexity between the EA and the PALCOM scale (low 22.3–23.7%; medium 57.2–59.0%; high 20.5–17.3%). The prevalence of high symptom burden, severe pain, functional impairment, socio-familial risk, existential/spiritual problems, 6-month mortality and in-hospital death was significantly higher (p < 0.001) at the high complexity levels in both scoring systems. Comparative analysis showed a high correlation rank and accuracy between the two scoring systems (Kendall’s tau test 0.81, F1 score 0.84). The predictive ability of the PALCOM scale was confirmed by an area under the curve in the ROC analysis of 0.907 for high and 0.902 for low complexity. Conclusions: In a patient-centred care model, the identification of complexity is a key point to appropriate referral and management of shared care with EPC teams. The PALCOM scale is a high precision tool for determining the level of complexity of palliative care needs.

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Section: Discussionmentioning

confidence: 99%

Validation Study of the PALCOM Scale of Complexity of Palliative Care Needs: A Cohort Study in Advanced Cancer Patients

Viladot,

Gallardo-Martínez,

Hernandez-Rodríguez

et al. 2023

Cancers

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“…In a highly complex status, the intervention of the specialized team should be mandatory. According to the present review, the IDC-Pal seems to be the most used instrument, having already been validated for several languages (15)(16)(17)(18)(19).…”

Section: Instruments Used In the Assessment Of Complexity In Patients...mentioning

confidence: 91%

Complexity of patient care needs in palliative care: a scoping review

Cerullo¹,

Videira-Silva²,

Carrancha³

et al. 2023

Ann Palliat Med

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Background: Recognizing the need for palliative care (PC) and referral to PC teams improves patients' quality of life. However, in patients with moderate/severe clinical complexity, early recognition of the need for PC may not correspond to referral to specialized PC services. The definition for clinical complexity is still underexplored, as well as the instruments available to assess complexity. This scoping review aims to gather relevant information on the definition of clinical complexity in PC, as well as on the instruments used to objectively assess complexity.Methods: According to the methodology of a Scoping Review, the keywords: "palliative care", "hospitalization criteria", "complexity criteria", "complexity assessment" and "clinical complexity", were searched in PubMed, Scopus, Cochrane, and b-on databases, during April 2022, for relevant information on the definition and/or approach and/or protocols related to clinical complexity in patients followed in PC, or on the instruments used to assess it, regardless of study design, the language, or year of publication.Results: From the 626 references found, 15 studies were included in the review. According to these studies, complexity may be organized/defined into 3, 4, or 6 domains, generally including the patient, the family, the health system, and the socio-cultural context. Of the 13 instruments mentioned for the objective assessment of complexity, the HexCom, IDC-Pal, and the recent ID-PALL seem to offer the broadest determinations of complexity.Conclusions: Complexity is a dynamic process, which reflects the reality of patients and families, and patients, families, and health professionals' perceptions, and so it must be systematically adjusted to the stage of the disease. The definition of complexity and the development and use of suitable instruments can help to identify, assess, and improve patients' quality of life, while supporting their family across the grieving process.Yet, this may not always be summarized in a quantitative value by easy-to-use instruments, highlighting the role of PC interdisciplinary teams.

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“…More specifically, questions refer to: the model (questions 2-15), Red (q. [16][17][18][19][20][21][22][23], Basic (q. 24-32), Clin (q.…”

Section: Design Of the Studymentioning

confidence: 99%

“…To the best of our knowledge, there are not available validated instruments based on this systemic approach, neither at a national level [19][20][21][22][23] nor at the international level [24,25,34,[26][27][28][29][30][31][32][33]. To overcome this deficit, between 2006 and 2017 a model (HexCom) has was designed to ultimately aid healthcare professionals caring for people with advanced illness and/or at the end of life.…”

mentioning

confidence: 99%

Assessing Face Validity of the Hexcom Model for Capturing Complexity in the Clinical Practice: A Delphi Study

Busquet-Duran¹,

Jiménez-Zafra²,

Tura-Poma³

et al. 2020

Preprint

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Capturing complexity is both a conceptual and a practical challenge in palliative care. The HexCom model has proved to be an instrument with strong reliability and valid for describing the needs and strengths of patients in home care. In order to explore whether it is also perceived to be helpful in enhancing coordinated and patient-centered care at a practical level, a methodological study was carried out to assess the face validity of the model. Particularly, a Delphi method involving a group of 15 experts representing the full spectrum of healthcare professionals involved in palliative care was carried out. The results show that there is a high level of agreement, with a Content Validity Index-Item greater than 0.92 both with regard to the complexity model and the HexCom-Red, HexCom-Basic and HexCom-Clin instruments, and higher than 0.85 regarding the HexCom-Figure and the HexCom-Patient instruments. This consensus confirms that the HexCom model and the different instruments that are derived from it are valued as useful tools for a broad range of healthcare professional in coordinately capturing of complexity in healthcare practice.

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Evaluation des spanischen Diagnostik-Tools für die Komplexität in der Palliativmedizin, IDC-Pal, durch Hausärzte in Deutschland: Eine Pilotstudie

Cited by 8 publications

References 13 publications

Validation Study of the PALCOM Scale of Complexity of Palliative Care Needs: A Cohort Study in Advanced Cancer Patients

Validation Study of the PALCOM Scale of Complexity of Palliative Care Needs: A Cohort Study in Advanced Cancer Patients

Complexity of patient care needs in palliative care: a scoping review

Assessing Face Validity of the Hexcom Model for Capturing Complexity in the Clinical Practice: A Delphi Study

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