POS results can be used to calculate individual item scores and an overall profile score.
The overall profile score is useful in understanding the overall experience and status of the patient and their needs and strengths at a specific point in time. The overall profile score is the sum of the scores from each of the 10 questions. The overall profile score can therefore range from zero to 40.
Individual item scores are useful when tracking particular dimensions, for example pain or spiritual need. POS has 10 items which assess the following dimensions: physical, emotional, psychological, spiritual and provision of information and support. As illustrated in question one, below, five response options are provided for each of these dimensions. Only one response is allowed for each question. In this example the patient scored four for question one.
Question 1: Over the past 3 days, have you been affected by pain?
0 Not at all, no effect
1 Slightly - but not bothered to be rid of it
2 Moderately - pain limits some activity
3 Severely - activities or concentration markedly affected
4 Overwhelmingly - unable to think of anything else
Question 11 allows the user to report what their main problems have been over the last three days. Although, this question isn’t scored, if additional problems are identified when this question is used, the problem identified can be scored using the response options from POS after the questionnaire has been completed.
Question 12 records information about how the scores were determined. The score from this question isn’t added to the overall profile score.
Guidance on the process of outcome measurement scoring is available.
How to score IPOS
IPOS results can be used to calculate i) individual item scores, ii) subscales, and iii) an overall IPOS score. Each is explained below.
Individual item scores are useful when tracking particular dimensions, for example pain, anxiety, or information needs.
IPOS has ten questions (17 items) which assess the following dimensions in advanced illness: physical, emotional, psychological, spiritual and provision of information and support. For the majority of items, five response options are provided, and only one response is allowed for each question.
Question 1 allows the user to report what their main problems have been. This question isn't scored but is used as a guide to what main problems or concerns are and how they are changing.
Question 2 addresses ten specific symptoms; for each of these, five answer options are possible (scored 0, 1, 2, 3, or 4). Note that the question is how much the patient has been AFFECTED by the symptom during the recall period, not how frequent or how severe it has been. Also note that staff IPOS scores may include the option 'can't assess' – this needs to be logged as 'can't assess', and cannot be used to contribute a numerical score. Similarly, a blank answer should be logged as 'missing data' and cannot be used to contribute a numerical score.
If additional symptoms are identified at the end of Question 2, the symptom or concern identified can be scored 0, 1, 2, 3, or 4, using the response options as for the 10 specific symptoms. However, if an additional symptom score is used to map a symptom over time, care should be taken to ensure that the same additional symptom is being reported by the respondent, and in the same order as previously.
Questions 3 to 9 address psychological, spiritual, communication, and practical symptoms or concerns; for each of these, five answer options are possible (scored 0, 1, 2, 3, or 4)., although note that the text descriptors of the answer options vary.
Questions 6, 7 and 8 seek benefits (e.g. ‘have you had as much information as you wanted?’) rather than concerns (e.g. ‘have you been feeling depressed?’), and so the direction of the text descriptors for these questions runs in the opposite direction to other questions.
Question 10 is not scored, but indicates who the respondent is, to inform interpretation.
Data on IPOS subscales is soon to be published; if any further details are required meanwhile, please contact the POS team on .
The overall IPOS score is useful in understanding the overall symptoms, concerns, and status of the patient at a specific point in time. The overall IPOS score is the sum of the scores from each of the 17 questions. The overall IPOS score can therefore range from zero to 68.
Note that Question 1, the additional symptoms from Question 2, and Question 10 are not included in the overall IPOS Score.
Note that total scores can mask important problems and should only be reported in addition to individual symptom scores. For instance, a low overall IPOS score might still have one or more items which are severe (scored 3) or overwhelming (scored 4).
Note also that if any items are marked ‘can’t assess’ or are missing, an overall IPOS Score cannot be generated.
