Background: The delivery of effective symptom control at the end of life depends largely on appropriate assessment particularly that which prioritises information obtained directly from patients. However, direct patient assessment is not always possible, leaving clinicians to act as patient proxies in estimating levels of symptom severity to plan the delivery of appropriate care. The literature suggests some disparity exists between the assessments of health professionals and those of their patients. Aim: To establish the level of agreement between the ratings of patients and clinical nurse specialists (CNS) in a large acute UK NHS university hospital. Method: A quantitative case study design with a cross-over element is being employed. 60 patients referred to the palliative care team will be recruited. The initial 30 patients will receive a routine visit by a CNS who will complete the Palliative Care Assessment tool (PACA) using the information gained. These patients will then receive a visit (within 1 hour) from a researcher who will code their direct responses using the same tool. This procedure will be reversed for the remaining 30 patients to limit the potential for bias. The data will be analysed using Kappa to assess the level of agreement between scores. Discussion: This paper will consider the difficulties in establishing this type of research including ethical and practical challenges. Suggestions for ways to overcome these challenges will be discussed, along with the value of this type of research for palliative care.
|Publication status||Published - 2004|
|Event||3rd Research Forum of the European Association for Palliative Care - Stresa, Italy|
Duration: 3 Jun 2004 → 6 Jun 2004
|Conference||3rd Research Forum of the European Association for Palliative Care|
|Period||3/06/04 → 6/06/04|