Chinese General Practice ›› 2025, Vol. 28 ›› Issue (31): 3981-3988.DOI: 10.12114/j.issn.1007-9572.2023.0227

Special Issue: 安宁疗护专题研究

• Evidence-based Medicine • Previous Articles    

Methodological Quality and Metrological Characteristics of Palliative Care Quality Assessment Tools for Cancer Patients: a Systematic Evaluation Based on COSMIN

  

  1. 1. School of Nursing, Zhuhai Campus of Zunyi Medical University, Zhuhai 519040, China
    2. Basic Teaching and Research Division of General Practice, Zhuhai Campus of Zunyi Medical University, Zhuhai 519040, China
  • Received:2024-12-15 Revised:2025-03-16 Published:2025-11-05 Online:2025-09-23
  • Contact: LIU Ning

癌症患者安宁疗护质量评估工具方法学质量和测量学特性的系统评价:基于COSMIN指南

  

  1. 1.519040 广东省珠海市,遵义医科大学珠海校区护理学系
    2.519040 广东省珠海市,遵义医科大学珠海校区全科医学基础教研室
  • 通讯作者: 刘宁
  • 作者简介:

    作者贡献:

    李婧菱、刘宁负责论文的修订与质量控制,对论文整体负责、监督管理;李婧菱、郭军负责文献检索、数据提取及图表绘制;刘宁负责研究的构思与设计,研究的实施与论文撰写;郭军负责论文的审查。

Abstract:

Background

Various tools for assessing the quality of palliative care for cancer patients have been developed both domestically and internationally, however, there is a lack of evaluative research on the measurement properties of these palliative care quality assessment tools, making it difficult for some palliative care teams to choose the best assessment tool.

Objective

To systematically evaluate the methodological quality and measurement properties of the palliative care quality assessment tools for cancer patients, providing evidence-based support for the clinical use of these assessment tools.

Methods

In March 2023, a computer-assisted search was conducted on databases including CNKI, VIP, CBM, Wanfang Data, PubMed, Web of Science, and Embase, for screening literature on the methodological quality and measurement properties of palliative care quality assessment tools for cancer patients. The search period was from the inception of the databases to February 6, 2023, and references of the included literature were traced to avoid missing any studies. Two researchers independently screened and assessed the included literature, using the COnsensus-based Standards for the selection of health Measurement Instrument (COSMIN) to systematically evaluate the methodological quality and measurement properties of palliative care quality assessment tools for cancer patients, and referring to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to form a recommendation grade for the evidence, ultimately forming a recommendation.

Results

A total of 11 literature involving 7 palliative care quality assessment tools for cancer patients were included, namely palliative care outcome scale (POS) , short form of the questionnaire quality from the patient's perspective for palliative care (SF-QPP-PC) , Consumer Assessment of Healthcare Providers and System Hospice Survey (HCAHPS) , functional assessment of cancer therapy-general (FACT-G) , rief hospice inventory (BHI) , Missoula-Vitas quality of life index (MVQOLI) , and care evaluation scale-patient version (CESP) . None of the palliative care quality assessment tools reported cross-cultural validity and measurement error in the included 11 literature; in terms of content validity, HCAHPS, FACT-G, BHI, and CESP were "not mentioned" , POS, SF-QPP-PC, and MVQOLI were "uncertain" ; in terms of structural validity, MVQOLI was "not mentioned" , SF-QPP-PC was "inadequate" , HCAHPS was "adequate" , and the other 4 assessment tools were "uncertain" ; in terms of internal consistency, BHI, MVQOLI, and CESP were "adequate" , POS, SF-QPP-PC, HCAHPS, and FACT-G were "inadequate" ; in terms of stability, SF-QPP-PC and MVQOLI were "not mentioned" , FACT-G was "adequate" , and the other 4 assessment tools were "inadequate" ; in terms of criterion validity, POS was "inadequate" ; in terms of hypothesis testing, SF-QPP-PC, HCAHPS, and BHI were "not mentioned" , CESP was "uncertain" , and the other 3 assessment tools were "adequate" ; in terms of responsiveness, POS and FACT-G were "uncertain" . Ultimately, the recommendation grade for POS, BHI, and MVQOLI was B, and for SF-QPP-PC, HCAHPS, FACT-G, and CESP was C.

Conclusion

Considering comprehensively, POS can be tentatively recommended (with a recommendation grade of B) , but overall, the methodological quality and measurement properties of palliative care quality assessment tools for cancer patients still need to be improved.

Key words: Neoplasms, Cancer, Hospice and palliative care nursing, Palliative care, Quality assessment tools, Methodological quality, Metrological characteristics, Systematic evaluation

摘要:

背景

国内外已开发出多种评估癌症患者安宁疗护质量的适用性工具,但尚无关于癌症患者安宁疗护质量评估工具测量学特性的评价性研究,造成部分安宁疗护团队难以选择最佳评估工具。

目的

系统评价癌症患者安宁疗护质量评估工具的方法学质量和测量学特性,为临床使用相应评估工具提供循证依据。

方法

2023年3月,采用计算机检索中国知网、维普网、中国生物医学文献数据库(CBM)、万方数据知识服务平台、PubMed、Web of Science、Embase,筛选关于癌症患者安宁疗护质量评估工具方法学质量与测量学特性的文献,检索时间为建库至2023-02-06;同时追溯纳入文献的参考文献以避免漏检。由两名研究者对检索到的文献独立进行筛选与评估,采用基于共识选择健康测量工具的标准(COSMIN)对癌症患者安宁疗护质量评估工具的方法学质量与测量学特性进行系统评价,并参考推荐分级的评估、制定与评价(GRADE)系统形成证据推荐等级,最终形成推荐意见。

结果

最终纳入11篇文献,共涉及7个癌症患者安宁疗护质量评估工具,分别为安宁疗护结果评定量表(POS)、患者角度安宁疗护质量简表(SF-QPP-PC)、CAHPS安宁疗护调查工具(HCAHPS)、癌症治疗功能评估量表(FACT-G)、简易临终关怀清单(BHI)、Missoula-Vitas生活质量指数(MVQOLI)、患者角度护理质量评价量表(CESP)。纳入的11篇文献所涉癌症患者安宁疗护质量评估工具均未报告跨文化效度和测量误差;在内容效度上,HCAHPS、FACT-G、BHI、CESP均为"未提及",POS、SF-QPP-PC、MVQOLI均为"不确定";在结构效度上,MVQOLI为"未提及",SF-QPP-PC为"不充分",HCAHPS为"充分",其余4个评估工具均为"不确定";在内部一致性上,BHI、MVQOLI、CESP均为"充分",POS、SF-QPP-PC、HCAHPS、FACT-G均为"不充分";在稳定性上,SF-QPP-PC、MVQOLI均为"未提及",FACT-G为"充分",其余4个评估工具均为"不充分";在效标效度上,POS为"不充分";在假设检验上,SF-QPP-PC、HCAHPS、BHI均为"未提及",CESP为"不确定",其余3个评估工具为"充分";在反应度上,POS、FACT-G为"不确定"。最终,POS、BHI、MVQOLI推荐等级为B级,SF-QPP-PC、HCAHPS、FACT-G、CESP推荐等级为C级。

结论

综合考虑,POS可被暂时推荐(推荐等级为B级),但整体上来看,癌症患者安宁疗护质量评估工具的方法学质量与测量学特性仍有待提高。

关键词: 肿瘤, 癌症, 临终关怀和姑息治疗护理, 安宁疗护, 质量评估工具, 方法学质量, 测量学特性, 系统评价

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