Abstract
BackgroundIdentification of patients who might benefit from palliative care among countries with different socioeconomic and medical contexts is challenging. The Supportive and Palliative Care Indicators Tool for a Low-income Setting (SPICT-LIS) was designed to help physicians identify patients in low-income setting who might benefit from palliative care. We aimed to systematically adapt and refine the SPICT-LIS for Thai general palliative care providers.MethodsWe followed the WHO guidelines for translation, cross-cultural adaptation and validation of an instrument for the SPICT-LIS. Three expert panel members did the initial adaptation using forward and backward translations with pretested data. Two iterations of pretesting were conducted to test for applicability and reliability. The case vignettes which were used in the pretesting were modified hospital medical records. The pretesting was done with 30 respondents from various specialties in a community health center and 34 general palliative care providers from a regional referral hospital in the first and second iterations, respectively. To examine instrument reliability, interrater reliability and internal consistency were evaluated. Cognitive interviewing was conducted using semi-structured interviews with general practitioners (GPs) using the “think aloud strategy” and “probing questions”.ResultsThe adapted Thai SPICT-LIS had a total of 34 indicators which included 6 general and 28 clinical indicators. The assessment of the adapted Thai SPICT-LIS found that it provided consistent responses with good agreement among the GPs, with a Fleiss kappa coefficient of 0.93 (0.76–1.00). The administration time was 2.3–4.3 min per case. Most respondents were female. The 8 interviewed GPs said they felt that the SPICT-LIS was appropriate for use in a general setting in Thailand.ConclusionThe study found that the Thai SPICT-LIS could be an applicable, acceptable, and reliable tool for general palliative care providers in Thailand to identify patients who might benefit from palliative care.
Highlights
Identification of patients who might benefit from palliative care among countries with different socioeconomic and medical contexts is challenging
According to one epidemiological study, the burdens of communicable and non-communicable diseases and injuries were remarkably higher in South-East Asia region (SEAR) countries than in high-income countries and there was a variety of disease contexts among the SEAR countries with different demographics and economic levels [3]
Various instruments have been introduced that can help healthcare workers identify patients who might benefit from palliative care [5]
Summary
Identification of patients who might benefit from palliative care among countries with different socioeconomic and medical contexts is challenging. Patients with life-limiting illnesses suffering from a wide range of diseases may be indicated for palliative care. Increases in the ageing population in most countries are adding to the burden of palliative care providers and creating new challenges to health policy makers. Disease burden may vary among different economic levels and country policies. According to one epidemiological study, the burdens of communicable and non-communicable diseases and injuries were remarkably higher in South-East Asia region (SEAR) countries than in high-income countries and there was a variety of disease contexts among the SEAR countries with different demographics and economic levels [3]
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