Identifying Nursing Home Residents with Unmet Palliative Care Needs: A Systematic Review of Screening Tool Measurement Properties
Abstract
Objectives: Despite common use of palliative care screening tools in other settings, the performance of these tools in the nursing home has not been well established, therefore, the purpose of this review is to (1) identify palliative care screening tools validated for nursing home residents; and (2) critically appraise, compare, and summarize the quality of measurement properties. Design: Systematic review of measurement properties consistent with Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidelines. Settings and participants: Embase (Ovid), MEDLINE (PubMed), CINAHL (EBSCO), and PsycInfo (Ovid), were searched from inception to May 2022. Studies that (1) reported the development or evaluation of a palliative care screening tool and (2) sampled older adults living in a nursing home were included. Methods: Two reviewers independently screened, selected, extracted data, and assessed risk of bias. Results: We identified only one palliative care screening tool meeting COSMIN criteria, the NECesidades Paliativas (NEC-PAL, equivalent to palliative needs in English), but evidence for use with nursing home residents was of low quality. The NEC-PAL lacked robust testing of measurement properties such as reliability, sensitivity and specificity in the nursing home setting. Construct validity through hypothesis testing was adequate but only reported in one study. Consequently, there is insufficient evidence to guide practice. Broadening the…
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