Development and validation of impact of early integration of palliative care and oncology(IEI PCO) questionnaire: a survey for medical oncologists and nurses

Objectives Many associations have recently recommended early integration of oncology and palliative care for more standard cancer care and better quality of life. We aimed to create a questionnaire to assess the opinion of medical oncologists and nurses about the clinical impact of the integrated palliative care and oncology (PCO) program. Methods A novel semi-structured questionnaire called Impact of Early Integration of Palliative Care Oncology (IEI PCO) questionnaire was developed and tested for validity and reliability then distributed to the oncologists and nurses working in Kuwait Cancer Control Center. Results After the pilot stage, testing the final questionnaire for validity and reliability was done with satisfactory results. Finally, the complete questionnaires were 170 out of 256 (response rate 66.41%). More awareness about the available palliative care services and the new available PCO services (p-value < 0.001 for all). Most of the oncologists and nurses agreed with the currently available structure of PCO, appreciated the patients' discharge plan and continuity of care of palliative medicine, admitted less work burden, a better attitude, and higher satisfaction (p-value for all < 0.001) toward palliative care. Significant improvements in symptoms were appreciated by oncologists and nurses after the integration of palliative care (p-value for all < 0.001. Oncologists and nurses valued repeated honest communication, discussion of the goals of care, dealing more effectively with ending active treatment, and higher acceptance of patients and families of PC policy of transfer, and significant progress in the care of end-of-life symptoms (p-value for all < 0.001). Conclusions The IEI PCO questionnaire demonstrated the psychometric criteria for content, face, and construct validity and reliability. It provides a valuable tool to assess the impact of PCO integration. The opinion of medical oncologists and nurses was significantly positive toward the early integration of PCO in Kuwait in most aspects of care. This integration led to improved symptom control, end-of-life care, communication, and planned discharge and follow-up plans. Moreover, decreases the work burden, improves attitude, higher satisfaction of the oncology staff, and continuity of care. Key message What is already known? Many studies proved the role of integrated palliative and oncology care but no available tools to assess this impact in clinical practice. What does this study add? center dot Impact of Early Integration of Palliative Care and Oncology Questionnaire (IEI PCO) is a newly developed and validated tool that can be used for evaluation of the impact of the PCO integration program. center dot It compares symptom control, end-of-life care, professional communication, structure, and clinical practice of PCO before and after integration and how this can affect the work burden, attitude, and satisfaction of oncology staff. How this study might affect research, practice, or policy? center dot It increases the awareness of oncology staff about the available PCO models such as ambulatory SPC team. The joint clinic, weekends round by SPC?etc center dot It can provide a guide to the important aspects that should be considered during the preparation of any PCO integration program and give feedback about aspects that need improvement.