Structured interview assessment of symptoms and concerns in palliative care.
OBJECTIVE
Assessment in palliative care requires a multidimensional review of physical symptoms and psychosocial concerns in a format appropriate for patients with advanced illness. In this study, we describe the initial development and validation of a structured interview for assessing common symptoms and concerns faced by terminally ill individuals.


METHODS
We constructed a 13-item Structured Interview for Symptoms and Concerns (SISC) based on a review of end-of-life issues and administered it to 69 patients receiving palliative care for advanced cancer. Along with the interview, each participant completed visual analog scales (VAS) addressing the same constructs. Test-retest and interrater reliability were determined, as was the concordance between interview ratings and VAS scores.


RESULTS
Overall, the interview items had excellent interrater reliability (intraclass correlations were > 0.90) and at least moderate temporal stability (test-retest correlations ranged from 0.50 to 0.90). Concurrent validity was evident in the good concordance between interview items and VAS measures (correlations were > 0.70). The SISC was also sensitive to individual differences between subgroups of participants who did or did not meet diagnostic criteria for anxiety or depressive disorders.


CONCLUSIONS
This study demonstrates that structured interviews provide a reliable and valid approach to assessment in palliative care and may be an appropriate alternative for some research applications.
Institute for Rehabilitation Research and Development, The Rehabilitation Centre, Ottawa, Ontario. kewilson@ottawahospital.on.ca
Keith G
KG
Wilson
Ian D
ID
Graham
Raymond A
RA
Viola
Susan
S
Chater
Barbara J
BJ
de Faye
Lynda A
LA
Weaver
Julie A
JA
Lachance
D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000523:psychology; D010146:Pain / Q000209:etiology / Q000523:psychology; D010166:Palliative Care; D015995:Prevalence; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires