Complex situations in palliative care: Development of a rating scale

Introduction. - The orientation of palliative care patients toward various hospital or non-hospital structures is highly person-dependent. We have developed a 10-item scale to assess the clinical complexity of palliative care patients, and initiated validation assessment by means of a prospective multicenter observational study. Our goal was to examine the inter-rater reliability. Method. - We analyzed 196 double quotations jointly carried out by two evaluators within 11 palliative care units of the Nord-Pas-de-Calais region. Results. - The analysis shows that the inter-rater reliability is low for 5 items out of 10. We note that these items are among the most subjective in the scale. Discussion. - Our results reflect different perceptions of the clinical complexity of the patient. These differences should be explored to improve the content validity of the scale. (C) 2014 Elsevier Masson SAS. All rights reserved.