Validity of the support team assessment schedule: do staffs' ratings reflect those made by patients or their families?

Abstract

This study aimed to assess the validity of the Support Team Assessment Schedule (STAS), a measure of the outcome of palliative care, through comparisons with the views of patients and family members. STAS ratings completed by two support teams were compared with (1) patients' ratings and (2) family member/carer ratings of seven (of the total 17 STAS) items, collected by independent interviewers. Of 183 patients referred to the teams, 84 (46%) were interviewed and 99 (54%) could not be contacted. Sixty-seven patients had family members or carers, all of whom were interviewed. Tests for agreement between team and patient were high for four items, and showed moderate correlations (Spearman's rho ranged 0.45-0.66) for five items, excepting two items including family needs. The summed scores for seven items were correlated, rho = 0.66, p < 0.0001. Where differences were found, team members identified more problems than patients' self-ratings, except for one item, 'pain control', where team members identified fewer problems. Team ratings were usually closer to those of the patients than to those of the family member; a team rating often lay between the patient's and family member's rating. The STAS is a measure of professional assessment which is independent from, although based on, the patient and family. The results support the validity of STAS as a measure of the outcome of palliative care from the perspective of a palliative care team.