title: Initial assessment of patients without cognitive failure admitted to palliative care: a validation study.
abstract: OBJECTIVE
  Many assessment tools have been developed for palliative care and there are a number of differences between them. Therefore, we felt that there was room for improvement.
  
  
  METHODS
  In a previous study, the relevant items were selected by a Delphi process with international experts in palliative care. A 5-point verbal scale was added to the items selected and adapted to the different kind of items.
  
  
  RESULTS
  The study included 123 patients, 63 (51%) were female and the median age was 64 (37 to 88). A four-factor structure was found through the principal components analysis, explaining 60.1% of the total variance. The scale presented good reliability, with a Cronbach's alpha of 0.72. It was hypothesized as a validity of construct that as the total symptom burden increased, survival time would decrease. This hypothesis was confirmed by the statistical analysis performed. A hazard ratio of 1.016 (P=0.019) was obtained in the Cox regression model including the final score as an explanatory variable of survival time, which means that for each increment of 1% in the total score, there was an increased risk of death of 1.6%.
  
  
  CONCLUSIONS
  This tool is in accordance with the recommended characteristics that an assessment tool should have. It is simple to administer and easy to explain, complete and analyze. It is also a valid tool.
authors.affiliation: Palliative Care Service, Portuguese Institute of Oncology, Porto, Portugal. ferrazg@ipoporto.min-saude.pt.
authors.forename: José António
authors.initials: JA
authors.lastname: Ferraz Gonçalves
authors.affiliation: Department of Epidemiology, Portuguese Institute of Oncology, Porto, Portugal.
authors.forename: Clara
authors.initials: C
authors.lastname: Castro
authors.affiliation: Palliative Care Service, Portuguese Institute of Oncology, Porto, Portugal.
authors.forename: Paula
authors.initials: P
authors.lastname: Silva
authors.affiliation: Palliative Care Service, Portuguese Institute of Oncology, Porto, Portugal.
authors.forename: Rui
authors.initials: R
authors.lastname: Carneiro
authors.affiliation: Palliative Care Service, Portuguese Institute of Oncology, Porto, Portugal.
authors.forename: Catarina
authors.initials: C
authors.lastname: Simões
authors.affiliation: Palliative Care Service, Portuguese Institute of Oncology, Porto, Portugal.
authors.forename: Isabel
authors.initials: I
authors.lastname: Costa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D016743:Mental Competency; D008875:Middle Aged; D010166:Palliative Care / Q000592:standards*; D010360:Patient Transfer / Q000592:standards; D011788:Quality of Life; D012044:Regression Analysis; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires / Q000592:standards
keywords: Palliative care; cognitive competence; construct validation; factorial analysis; symptom assessment