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Research Article
Validity and reliability of the English and translated Chinese versions of the Integrated Palliative care Outcome Scale (IPOS) in Singapore
Grace Yang
National Cancer Centre Singapore
Corresponding Author
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This work is licensed under a CC BY 4.0 License. Read Full License
Context: Measurement of patient-centred outcomes enables clinicians to focus on patient and family priorities and enables quality of palliative care to be assessed.
Objectives: This study aimed to evaluate the validity and reliability of the English and translated Chinese IPOS among advanced cancer patients in Singapore.
Methods: IPOS was forward and backward translated from English into Chinese. Structural validity was assessed by confirmatory factor analysis; known-group validity by comparing inpatients and community patients; construct validity by correlating IPOS with Edmonton Symptom Assessment System-revised (ESAS-r) and Functional Assessment of Cancer Therapy–General (FACT-G); internal consistency by Cronbach’s alpha; inter-rater reliability between patient and staff responses; test-retest reliability of patient responses between two timepoints.
Results: 111 English-responding and 109 Chinese-responding patients participated. The three-factor structure (Physical Symptoms, Emotional Symptoms and Communication and Practical Issues) was confirmed with Comparative Fit Index and Tucker-Lewis-Index > 0.9 and Root Mean Square Error of Approximation < 0.08. Inpatients scored higher than outpatients as hypothesised. Construct validity (Pearson’s correlation coefficient, r≥|0.608|) was shown between the related subscales of IPOS and FACT-G and ESAS-r. Internal consistency was confirmed for total and subscale scores (Cronbach's alpha ≥ 0.84), except for the Communication and Practical Issues subscale (Cronbach’s alpha = 0.29–0.65). Inter-rater reliability (Intra-class correlation coefficient [ICC] ≤ 0.43) between patient and staff responses was insufficient. Test-retest reliability was confirmed with Intra-class correlation coefficient ICC = 0.80 (English) and 0.88 (Chinese) for IPOS Total.
Conclusion: IPOS in English and Chinese showed good validity, good internal consistency, and good test-retest reliability, except for the Communication and Practical Issues subscale. There was poor inter-rater reliability between patients and staff.
Keywords
Palliative care, patient-centred outcomes, advanced cancer, IPOS, reliability, validity
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CURRENT STATUS: Under Review
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Posted 16 Dec, 2020
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Review #2 received
Received 21 Jan, 2021
Reviewer #5 agreed
On 30 Dec, 2020
Reviewer #4 agreed
On 30 Dec, 2020
Reviewer #6 agreed
On 30 Dec, 2020
Reviewer #3 agreed
On 30 Dec, 2020
Review #15 received
Received 22 Dec, 2020
Review #1 received
Received 22 Dec, 2020
Review #12 received
Received 22 Dec, 2020
Review #14 received
Received 22 Dec, 2020
Review #11 received
Received 22 Dec, 2020
Review #16 received
Received 22 Dec, 2020
Review #9 received
Received 22 Dec, 2020
Review #10 received
Received 22 Dec, 2020
Review #13 received
Received 22 Dec, 2020
Reviewer #16 agreed
On 21 Dec, 2020
Reviewer #2 agreed
On 21 Dec, 2020
Reviewer #13 agreed
On 21 Dec, 2020
Reviewer #1 agreed
On 21 Dec, 2020
Reviewer #15 agreed
On 21 Dec, 2020
Reviewer #12 agreed
On 21 Dec, 2020
Reviewer #17 agreed
On 21 Dec, 2020
Reviewer #10 agreed
On 21 Dec, 2020
Reviewer #11 agreed
On 21 Dec, 2020
Reviewer #14 agreed
On 21 Dec, 2020
Reviewers invited
Invitations sent on 21 Dec, 2020
Editor assigned
On 15 Dec, 2020
Editor invited
On 15 Dec, 2020
Submission checks complete
On 15 Dec, 2020
First submitted
On 02 Dec, 2020
Metrics
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Subject Areas
Anesthesiology & Pain Medicine
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This preprint is under consideration at BMC Palliative Care. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Validity and reliability of the English and translated Chinese versions of the Integrated Palliative care Outcome Scale (IPOS) in Singapore
Grace Yang
National Cancer Centre Singapore
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 16 Dec, 2020
No community comments so far
Review #2 received
Received 21 Jan, 2021
Reviewer #5 agreed
On 30 Dec, 2020
Reviewer #4 agreed
On 30 Dec, 2020
Reviewer #6 agreed
On 30 Dec, 2020
Reviewer #3 agreed
On 30 Dec, 2020
Review #15 received
Received 22 Dec, 2020
Review #1 received
Received 22 Dec, 2020
Review #12 received
Received 22 Dec, 2020
Review #14 received
Received 22 Dec, 2020
Review #11 received
Received 22 Dec, 2020
Review #16 received
Received 22 Dec, 2020
Review #9 received
Received 22 Dec, 2020
Review #10 received
Received 22 Dec, 2020
Review #13 received
Received 22 Dec, 2020
Reviewer #16 agreed
On 21 Dec, 2020
Reviewer #2 agreed
On 21 Dec, 2020
Reviewer #13 agreed
On 21 Dec, 2020
Reviewer #1 agreed
On 21 Dec, 2020
Reviewer #15 agreed
On 21 Dec, 2020
Reviewer #12 agreed
On 21 Dec, 2020
Reviewer #17 agreed
On 21 Dec, 2020
Reviewer #10 agreed
On 21 Dec, 2020
Reviewer #11 agreed
On 21 Dec, 2020
Reviewer #14 agreed
On 21 Dec, 2020
Reviewers invited
Invitations sent on 21 Dec, 2020
Editor assigned
On 15 Dec, 2020
Editor invited
On 15 Dec, 2020
Submission checks complete
On 15 Dec, 2020
First submitted
On 02 Dec, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Anesthesiology & Pain Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Context: Measurement of patient-centred outcomes enables clinicians to focus on patient and family priorities and enables quality of palliative care to be assessed.
Objectives: This study aimed to evaluate the validity and reliability of the English and translated Chinese IPOS among advanced cancer patients in Singapore.
Methods: IPOS was forward and backward translated from English into Chinese. Structural validity was assessed by confirmatory factor analysis; known-group validity by comparing inpatients and community patients; construct validity by correlating IPOS with Edmonton Symptom Assessment System-revised (ESAS-r) and Functional Assessment of Cancer Therapy–General (FACT-G); internal consistency by Cronbach’s alpha; inter-rater reliability between patient and staff responses; test-retest reliability of patient responses between two timepoints.
Results: 111 English-responding and 109 Chinese-responding patients participated. The three-factor structure (Physical Symptoms, Emotional Symptoms and Communication and Practical Issues) was confirmed with Comparative Fit Index and Tucker-Lewis-Index > 0.9 and Root Mean Square Error of Approximation < 0.08. Inpatients scored higher than outpatients as hypothesised. Construct validity (Pearson’s correlation coefficient, r≥|0.608|) was shown between the related subscales of IPOS and FACT-G and ESAS-r. Internal consistency was confirmed for total and subscale scores (Cronbach's alpha ≥ 0.84), except for the Communication and Practical Issues subscale (Cronbach’s alpha = 0.29–0.65). Inter-rater reliability (Intra-class correlation coefficient [ICC] ≤ 0.43) between patient and staff responses was insufficient. Test-retest reliability was confirmed with Intra-class correlation coefficient ICC = 0.80 (English) and 0.88 (Chinese) for IPOS Total.
Conclusion: IPOS in English and Chinese showed good validity, good internal consistency, and good test-retest reliability, except for the Communication and Practical Issues subscale. There was poor inter-rater reliability between patients and staff.
Figure 1