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Evaluation of the Palliative Care Outcome Scale (POS) in chronic heart failure patients
  1. A Ma1,
  2. J Reid2,
  3. A Ness2,
  4. M O'Donnell2,
  5. D Yellowless2,
  6. K Boyd3,
  7. S A Murray3 and
  8. M Denvir2
  1. 1College of Medicine and Veterinary Medicine, University of Edinburgh, UK
  2. 2Edinburgh Heart Centre, Royal Infirmary of Edinburgh, Edinburgh, UK
  3. 3Primary Palliative Care Research Group, Centre for Population Health Science, University of Edinburgh Medical School, Edinburgh, UK

Abstract

Introduction Patients with chronic heart failure (CHF) suffer significant mortality and morbidity. New patient-centred methods of assessing quality of life are needed that focus on supportive and palliative care needs. We aimed to assess a previously validated palliative care outcome scale (POS) questionnaire in patients with CHF.

Methods Patients seen by Specialist Heart Failure Nurses in outpatient clinics and on home visits were recruited. POS questionnaires were completed by patients at three time points over an 8 week period. Specialist Heart Failure Nurses completed a POS at baseline for each patient. Patients completed the Euroqol EQ5D at the end of the study.

Results Average age was 73, and all patients had left ventricular failure. 32 patients completed the baseline questionnaire; 25 completed questionnaires at all 3 time points. Patient POS scores were significantly consistent between time points (p<0.0001) and a significant correlation was found between patient POS and EQ5D scores (p=0.019). Patient POS scores did not correlate significantly with staff POS scores, NYHA class, number of comorbidities or mortality predicted by the Seattle Heart Failure Model. Staff POS scores under-predicted patient scores for 20 out of 28 patients.

Conclusion Consistency between POS scores at different time points and a significant correlation to EQ5D scores suggest that the POS questionnaire has a degree of robustness in assessing patient-perceived quality of life. The lack of correlation between patient perception and ‘objective’ measures of health deserves further exploration, as does the apparent over-estimation of quality of life by nursing staff.

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