Palliative Care Phase: Inter-rater reliability and acceptability in a national study

M. Masso, S.F. Allingham, M. Banfield, Claire Johnson, Tanya Pidgeon, P. Yates, K.M. Eagar

    Research output: Contribution to journalArticle

    28 Citations (Scopus)

    Abstract

    © The Author(s) 2014. Background: The concept of palliative care consisting of five distinct, clinically meaningful, phases (stable, unstable, deteriorating, terminal and bereavement) was developed in Australia about 20 years ago and is used routinely for communicating clinical status, care planning, quality improvement and funding. Aim: To test the reliability and acceptability of revised definitions of Palliative Care Phase. Design: Multi-centre cross-sectional study involving pairs of clinicians independently rating patients according to revised definitions of Palliative Care Phase. Setting/participants: Clinicians from 10 Australian palliative care services, including 9 inpatient units and 1 mixed inpatient/community-based service. Results: A total of 102 nursing and medical clinicians participated, undertaking 595 paired assessments of 410 patients, of which 90.7% occurred within 2 h. Clinicians rated 54.8% of patients in the stable phase, 15.8% in the unstable phase, 20.8% in the deteriorating phase and 8.7% in the terminal phase. Overall agreement between clinicians' rating of Palliative Care Phase was substantial (kappa = 0.67; 95% confidence interval = 0.61-0.70). A moderate level of inter-rater reliability was apparent across all participating sites. The results indicated that Palliative Care Phase was an acceptable measure, with no significant difficulties assigning patients to a Palliative Care Phase and a good fit between assessment of phase and the definition of that phase. The most difficult phase to distinguish from other phases was the deteriorating phase. Conclusion: Policy makers, funders and clinicians can be confident that Palliative Care Phase is a reliable and acceptable measure that can be used for care planning, quality improvement and funding purposes.
    Original languageEnglish
    Pages (from-to)22-30
    JournalPalliative Medicine
    Volume29
    Issue number1
    DOIs
    Publication statusPublished - 2015

    Fingerprint

    Palliative Care
    Quality Improvement
    Inpatients
    Bereavement
    Social Welfare
    Administrative Personnel
    Nursing
    Cross-Sectional Studies
    Confidence Intervals

    Cite this

    Masso, M., Allingham, S. F., Banfield, M., Johnson, C., Pidgeon, T., Yates, P., & Eagar, K. M. (2015). Palliative Care Phase: Inter-rater reliability and acceptability in a national study. Palliative Medicine, 29(1), 22-30. https://doi.org/10.1177/0269216314551814
    Masso, M. ; Allingham, S.F. ; Banfield, M. ; Johnson, Claire ; Pidgeon, Tanya ; Yates, P. ; Eagar, K.M. / Palliative Care Phase: Inter-rater reliability and acceptability in a national study. In: Palliative Medicine. 2015 ; Vol. 29, No. 1. pp. 22-30.
    @article{621d476307004fb093e4783bfb8860e1,
    title = "Palliative Care Phase: Inter-rater reliability and acceptability in a national study",
    abstract = "{\circledC} The Author(s) 2014. Background: The concept of palliative care consisting of five distinct, clinically meaningful, phases (stable, unstable, deteriorating, terminal and bereavement) was developed in Australia about 20 years ago and is used routinely for communicating clinical status, care planning, quality improvement and funding. Aim: To test the reliability and acceptability of revised definitions of Palliative Care Phase. Design: Multi-centre cross-sectional study involving pairs of clinicians independently rating patients according to revised definitions of Palliative Care Phase. Setting/participants: Clinicians from 10 Australian palliative care services, including 9 inpatient units and 1 mixed inpatient/community-based service. Results: A total of 102 nursing and medical clinicians participated, undertaking 595 paired assessments of 410 patients, of which 90.7{\%} occurred within 2 h. Clinicians rated 54.8{\%} of patients in the stable phase, 15.8{\%} in the unstable phase, 20.8{\%} in the deteriorating phase and 8.7{\%} in the terminal phase. Overall agreement between clinicians' rating of Palliative Care Phase was substantial (kappa = 0.67; 95{\%} confidence interval = 0.61-0.70). A moderate level of inter-rater reliability was apparent across all participating sites. The results indicated that Palliative Care Phase was an acceptable measure, with no significant difficulties assigning patients to a Palliative Care Phase and a good fit between assessment of phase and the definition of that phase. The most difficult phase to distinguish from other phases was the deteriorating phase. Conclusion: Policy makers, funders and clinicians can be confident that Palliative Care Phase is a reliable and acceptable measure that can be used for care planning, quality improvement and funding purposes.",
    author = "M. Masso and S.F. Allingham and M. Banfield and Claire Johnson and Tanya Pidgeon and P. Yates and K.M. Eagar",
    year = "2015",
    doi = "10.1177/0269216314551814",
    language = "English",
    volume = "29",
    pages = "22--30",
    journal = "Palliative Medicine",
    issn = "0269-2163",
    publisher = "SAGE Publications Ltd",
    number = "1",

    }

    Masso, M, Allingham, SF, Banfield, M, Johnson, C, Pidgeon, T, Yates, P & Eagar, KM 2015, 'Palliative Care Phase: Inter-rater reliability and acceptability in a national study' Palliative Medicine, vol. 29, no. 1, pp. 22-30. https://doi.org/10.1177/0269216314551814

    Palliative Care Phase: Inter-rater reliability and acceptability in a national study. / Masso, M.; Allingham, S.F.; Banfield, M.; Johnson, Claire; Pidgeon, Tanya; Yates, P.; Eagar, K.M.

    In: Palliative Medicine, Vol. 29, No. 1, 2015, p. 22-30.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Palliative Care Phase: Inter-rater reliability and acceptability in a national study

    AU - Masso, M.

    AU - Allingham, S.F.

    AU - Banfield, M.

    AU - Johnson, Claire

    AU - Pidgeon, Tanya

    AU - Yates, P.

    AU - Eagar, K.M.

    PY - 2015

    Y1 - 2015

    N2 - © The Author(s) 2014. Background: The concept of palliative care consisting of five distinct, clinically meaningful, phases (stable, unstable, deteriorating, terminal and bereavement) was developed in Australia about 20 years ago and is used routinely for communicating clinical status, care planning, quality improvement and funding. Aim: To test the reliability and acceptability of revised definitions of Palliative Care Phase. Design: Multi-centre cross-sectional study involving pairs of clinicians independently rating patients according to revised definitions of Palliative Care Phase. Setting/participants: Clinicians from 10 Australian palliative care services, including 9 inpatient units and 1 mixed inpatient/community-based service. Results: A total of 102 nursing and medical clinicians participated, undertaking 595 paired assessments of 410 patients, of which 90.7% occurred within 2 h. Clinicians rated 54.8% of patients in the stable phase, 15.8% in the unstable phase, 20.8% in the deteriorating phase and 8.7% in the terminal phase. Overall agreement between clinicians' rating of Palliative Care Phase was substantial (kappa = 0.67; 95% confidence interval = 0.61-0.70). A moderate level of inter-rater reliability was apparent across all participating sites. The results indicated that Palliative Care Phase was an acceptable measure, with no significant difficulties assigning patients to a Palliative Care Phase and a good fit between assessment of phase and the definition of that phase. The most difficult phase to distinguish from other phases was the deteriorating phase. Conclusion: Policy makers, funders and clinicians can be confident that Palliative Care Phase is a reliable and acceptable measure that can be used for care planning, quality improvement and funding purposes.

    AB - © The Author(s) 2014. Background: The concept of palliative care consisting of five distinct, clinically meaningful, phases (stable, unstable, deteriorating, terminal and bereavement) was developed in Australia about 20 years ago and is used routinely for communicating clinical status, care planning, quality improvement and funding. Aim: To test the reliability and acceptability of revised definitions of Palliative Care Phase. Design: Multi-centre cross-sectional study involving pairs of clinicians independently rating patients according to revised definitions of Palliative Care Phase. Setting/participants: Clinicians from 10 Australian palliative care services, including 9 inpatient units and 1 mixed inpatient/community-based service. Results: A total of 102 nursing and medical clinicians participated, undertaking 595 paired assessments of 410 patients, of which 90.7% occurred within 2 h. Clinicians rated 54.8% of patients in the stable phase, 15.8% in the unstable phase, 20.8% in the deteriorating phase and 8.7% in the terminal phase. Overall agreement between clinicians' rating of Palliative Care Phase was substantial (kappa = 0.67; 95% confidence interval = 0.61-0.70). A moderate level of inter-rater reliability was apparent across all participating sites. The results indicated that Palliative Care Phase was an acceptable measure, with no significant difficulties assigning patients to a Palliative Care Phase and a good fit between assessment of phase and the definition of that phase. The most difficult phase to distinguish from other phases was the deteriorating phase. Conclusion: Policy makers, funders and clinicians can be confident that Palliative Care Phase is a reliable and acceptable measure that can be used for care planning, quality improvement and funding purposes.

    U2 - 10.1177/0269216314551814

    DO - 10.1177/0269216314551814

    M3 - Article

    VL - 29

    SP - 22

    EP - 30

    JO - Palliative Medicine

    JF - Palliative Medicine

    SN - 0269-2163

    IS - 1

    ER -