Self-report measurement of pain & symptoms in palliative care patients: a comparison of verbal, visual and hand scoring methods in Sub-Saharan Africa

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dc.contributor.authorBlum, David
dc.contributor.authorSelman, Lucy E
dc.contributor.authorAgupio, Godfrey
dc.contributor.authorMashao, Thandi
dc.contributor.authorMmoledi, Keletso
dc.contributor.authorMoll, Tony
dc.contributor.authorDinat, Natalya
dc.contributor.authorGwyther, Liz
dc.contributor.authorSebuyira, Lydia M
dc.contributor.authorIkin, Barbara
dc.contributor.authorDowning, Julia
dc.contributor.authorKaasa, Stein
dc.contributor.authorHigginson, Irene J
dc.contributor.authorHarding, Richard
dc.date.accessioned2015-02-16T12:52:44Z
dc.date.available2015-02-16T12:52:44Z
dc.date.issued2014-08-02
dc.date.updated2015-01-15T17:57:14Z
dc.description.abstractBackground: Despite a high incidence of life-limiting disease, there is a deficit of palliative care outcome evidence in sub-Saharan Africa. Providers of end of life care call for appropriate measurement tools. The objective is to compare four approaches to self-report pain and symptom measurement among African palliative care patients completing the African Palliative Care Association African Palliative Outcome Scale (APCA African POS). Methods: Patients were recruited from five services (4 in South Africa and 1 in Uganda). Research nurses cross-sectionally administered POS pain and symptom items in local languages. Both questions were scored from 0 to 5 using 4 methods: verbal rating, demonstrating the score using the hand (H), selecting a face on a visual scale (F), and indicating a point on the Jerrycan visual scale (J). H, F and J scores were correlated with verbal scores as reference using Spearman’s rank and weighted Kappa. A Receiver Operating Characteristic (ROC) analysis was performed. Results: 315 patients participated (mean age 43.5 years, 69.8% female), 71.1% were HIV positive and 35.6% had cancer, 49.2% lived in rural areas. Spearman’s rank correlations for pain scores were: H: 0.879, F: 0.823, J: 0.728 (all p < 0.001); for symptoms H: 0.876, F: 0.808, J: 0.721 (all p < 0.001). Weighted Kappa for pain was H: 0.798, F: 0.719 J: 0.548 and for symptoms: H: 0.818, F: 0.718, J: 0.571. There was lower agreement between verbal and both hand and face scoring methods in the Ugandan sample. Compared to the verbal scale the accuracy of predicting high pain/symptoms was H > F > J (0.96–0.89) in ROC analysis. Conclusions: Hands and faces scoring methods correlate highly with verbal scoring. The Jerrycan method had only moderate weighted Kappa. POS scores can be reliably measured using hand or face score.en_ZA
dc.identifier.apacitationBlum, D., Selman, L. E., Agupio, G., Mashao, T., Mmoledi, K., Moll, T., ... Harding, R. (2014). Self-report measurement of pain & symptoms in palliative care patients: a comparison of verbal, visual and hand scoring methods in Sub-Saharan Africa. <i>Health and Quality of Life Outcomes</i>, http://hdl.handle.net/11427/12486en_ZA
dc.identifier.chicagocitationBlum, David, Lucy E Selman, Godfrey Agupio, Thandi Mashao, Keletso Mmoledi, Tony Moll, Natalya Dinat, et al "Self-report measurement of pain & symptoms in palliative care patients: a comparison of verbal, visual and hand scoring methods in Sub-Saharan Africa." <i>Health and Quality of Life Outcomes</i> (2014) http://hdl.handle.net/11427/12486en_ZA
dc.identifier.citationBlum, D., Selman, L. E., Agupio, G., Mashao, T., Mmoledi, K., Moll, T., ... & Harding, R. (2014). Self-report measurement of pain & symptoms in palliative care patients: a comparison of verbal, visual and hand scoring methods in Sub-Saharan Africa. Health Qual Life Outcomes, 12(1), 118.en_ZA
dc.identifier.issn1477-7525
dc.identifier.ris TY - Journal Article AU - Blum, David AU - Selman, Lucy E AU - Agupio, Godfrey AU - Mashao, Thandi AU - Mmoledi, Keletso AU - Moll, Tony AU - Dinat, Natalya AU - Gwyther, Liz AU - Sebuyira, Lydia M AU - Ikin, Barbara AU - Downing, Julia AU - Kaasa, Stein AU - Higginson, Irene J AU - Harding, Richard AB - Background: Despite a high incidence of life-limiting disease, there is a deficit of palliative care outcome evidence in sub-Saharan Africa. Providers of end of life care call for appropriate measurement tools. The objective is to compare four approaches to self-report pain and symptom measurement among African palliative care patients completing the African Palliative Care Association African Palliative Outcome Scale (APCA African POS). Methods: Patients were recruited from five services (4 in South Africa and 1 in Uganda). Research nurses cross-sectionally administered POS pain and symptom items in local languages. Both questions were scored from 0 to 5 using 4 methods: verbal rating, demonstrating the score using the hand (H), selecting a face on a visual scale (F), and indicating a point on the Jerrycan visual scale (J). H, F and J scores were correlated with verbal scores as reference using Spearman’s rank and weighted Kappa. A Receiver Operating Characteristic (ROC) analysis was performed. Results: 315 patients participated (mean age 43.5 years, 69.8% female), 71.1% were HIV positive and 35.6% had cancer, 49.2% lived in rural areas. Spearman’s rank correlations for pain scores were: H: 0.879, F: 0.823, J: 0.728 (all p < 0.001); for symptoms H: 0.876, F: 0.808, J: 0.721 (all p < 0.001). Weighted Kappa for pain was H: 0.798, F: 0.719 J: 0.548 and for symptoms: H: 0.818, F: 0.718, J: 0.571. There was lower agreement between verbal and both hand and face scoring methods in the Ugandan sample. Compared to the verbal scale the accuracy of predicting high pain/symptoms was H > F > J (0.96–0.89) in ROC analysis. Conclusions: Hands and faces scoring methods correlate highly with verbal scoring. The Jerrycan method had only moderate weighted Kappa. POS scores can be reliably measured using hand or face score. DA - 2014-08-02 DB - OpenUCT DO - 10.1186/s12955-014-0118-z DP - University of Cape Town J1 - Health and Quality of Life Outcomes LK - https://open.uct.ac.za PB - University of Cape Town PY - 2014 SM - 1477-7525 T1 - Self-report measurement of pain & symptoms in palliative care patients: a comparison of verbal, visual and hand scoring methods in Sub-Saharan Africa TI - Self-report measurement of pain & symptoms in palliative care patients: a comparison of verbal, visual and hand scoring methods in Sub-Saharan Africa UR - http://hdl.handle.net/11427/12486 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/12486
dc.identifier.urihttp://dx.doi.org/10.1186/s12955-014-0118-z
dc.identifier.vancouvercitationBlum D, Selman LE, Agupio G, Mashao T, Mmoledi K, Moll T, et al. Self-report measurement of pain & symptoms in palliative care patients: a comparison of verbal, visual and hand scoring methods in Sub-Saharan Africa. Health and Quality of Life Outcomes. 2014; http://hdl.handle.net/11427/12486.en_ZA
dc.languageengen_ZA
dc.language.rfc3066en
dc.publisherBioMed Centralen_ZA
dc.publisher.departmentDepartment of Public Health and Family Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsCreative Commons Attribution 4.0 International (CC BY 4.0)*
dc.rights.holderBlum et al.; licensee BioMed Central Ltd.
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_ZA
dc.sourceHealth and Quality of Life Outcomesen_ZA
dc.source.urihttp://www.hqlo.com/
dc.titleSelf-report measurement of pain & symptoms in palliative care patients: a comparison of verbal, visual and hand scoring methods in Sub-Saharan Africaen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetype
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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