Supportive and palliative care indicators tool (SPICT™) in a Danish healthcare context: translation, cross-cultural adaptation, and content validation

Abstract

Background Early identification of patients who require palliative and supportive care at the general palliative care level is challenging. The Supportive & Palliative Care Indicators Tool (SPICT™) might provide a helpful framework for this process. Aim To translate, culturally adapt and content validate SPICT™-DK in hospital, primary care, and general practice and within the broader Danish health care context. Methods SPICT™-DK was translated and cross-culturally validated by using the TRAPD-model (Translation, Review, adjudication, pretesting, and documentation) as well as the EORTC- translation guide (European Organisation for Research and Treatment of Cancer). In the pre-(pilot) testing phase, six focus group interviews and five individual interviews were conducted involving n = 29 health care professionals from general practice, primary care, and hospital. The qualitative data were analyzed through thematic analysis and the SPICT™-DK was then revised and published. Results The interviews revealed that SPICT™-DK can be used to identify people with palliative care needs. Three themes were derived from the analysis and showed SPICT™-DK provides a linguistic framework but must be used as an interdisciplinary tool as that SPICT™-DK requires competencies and collaboration. Conclusion SPICT™-DK is now translated and culturally validated in a Danish healthcare setting. The tool is useful to identify people with palliative care needs but must be implemented as an interdisciplinary collaborative intervention. SPICT™ -DK cannot be used by all healthcare professionals as it requires disease-specific competencies. However, it provides a common language for early palliative care interventions which can form the basis for interdisciplinary planning of future treatment and care.

Use of the supportive and palliative care indicators tool (SPICT™) for end-of-life discussions: a scoping review

“…Two studies designed to translate and validate the SPICT-DK™ (Danish) [ 21 ] and SPICT-SE™ (Swedish) [ 24 ] involving focus groups with health care professionals revealed positive responses from doctors and nurses. The tool was described as a linguistic framework among these professionals and that use of the SPICT™ gave them a common language in which to collaborate and focus when treating and caring for patients [ 21 ]. The specificity of the tool was highlighted by nurses and medical doctors [ 24 ].…”

“…The SPICT ™ has been translated, cross culturally adapted and validated to identify patients with palliative care needs in Danish [ 21 ] and German [ 38 ] using the Translation, Review, Adjudication, Pre-testing and Documentation (TRAPD) model. Another study by Afshar, et al [ 32 ] further established the validity of the SPICT-DE ™ in German in general practice with a patient cohort.…”

Barriers to and facilitators of successful implementation of a palliative approach to care in primary care practices: a mixed methods study

“…The EPIC protocol had PCPs use and implement multiple tools to help identify individuals who were appropriate for early palliative care. These tools included the Edmonton Symptom Assessment System (ESAS),22 Palliative Performance Scale (PPS)23 and the Supportive and Palliative Care Indicators Tool (SPICT) 24. EPIC emphasised that providers needed to document tool results so patients could be monitored over time and results could be used to inform decisions on changes to care.…”