title: Care evaluation scale-patient version: measuring the quality of the structure and process of palliative care from the patient's perspective.
abstract: BACKGROUND
  Recently, greater emphasis has been placed on patient-reported outcomes. However, there are only a few measures to evaluate the quality of care from the patient's perspective.
  
  
  OBJECTIVE
  To report the development of a scale to measure the quality of the structure and process in palliative care from the patient's perspective and examine the reliability and validity of the scale.
  
  
  METHODS
  A cross-sectional anonymous questionnaire was administered to cancer patients who were being treated on an oncology inpatient ward, who visited an oncology outpatient clinic at Saitama Medical University International Medical Center, or who were in an inpatient palliative unit in Japan between August 2007 and March 2008.
  
  
  RESULTS
  A total of 405 cancer patients participated in the study. Factor analysis revealed that the Care Evaluation Scale-Patient version (CES-P) consisted of 23 items with eight subscales: physical care by physicians, physical care by nurses, psychoexistential care, help with decision making for patients, environment, cost, availability, and coordination/consistency. The total CES-P score was correlated with satisfaction (r = 0.63) but not with quality of life (r = 0.18). The Cronbach α coefficient of the total score was 0.97, and the intraclass correlation coefficient of the total score was 0.67. The CES-P total score was not significantly correlated with the self-reported Eastern Cooperative Oncology Group performance status (ρ = -0.05).
  
  
  CONCLUSIONS
  The CES-P has sufficient validity and reliability. In addition, this scale is independent of the general physical condition of the patient.
authors.affiliation: Division of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Adult Nursing/Palliative Care Nursing, School of Health Sciences and Nursing Sciences, Graduate School of Medicine, The University of Tokyo, Sendai, Japan. Electronic address: miyasita-tky@umin.net.
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Miyashita
authors.affiliation: Department of Psycho-Oncology and Palliative Medicine, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Wada
authors.affiliation: Department of Palliative and Supportive Care, Palliative Care Team and Seirei Hospice, Seirei Mikatahara Hospital, Shizuoka, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Morita
authors.affiliation: Department of Psycho-Oncology, Saitama Cancer Center, Saitama, Japan.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Ishida
authors.affiliation: Department of Psycho-Oncology, Saitama Cancer Center, Saitama, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Onishi
authors.affiliation: Department of Palliative Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Tsuneto
authors.affiliation: Department of Palliative Medicine, Tsukuba Medical Center Hospital, Ibaraki, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Shima
mesh_terms: D003430:Cross-Sectional Studies; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology; D007564:Japan; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy*; D010045:Outpatients / Q000523:psychology; D010166:Palliative Care / Q000379:methods*; D017060:Patient Satisfaction; D011785:Quality Assurance, Health Care / Q000379:methods*; D011788:Quality of Life; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
keywords: Palliative care; hospice; neoplasms; quality of care; questionnaires