There are currently two versions of POS: POS v1 and POS v2. The main difference between them is on question 7, which asks if life is worthwhile in v1 and about depression in v2.
How did the difference between POS v1 and POS v2 come about?
POS v1 was developed first and validated in eight different settings, including hospital, community, in-patient hospice, outpatient, day care and general practice.
During this development and with subsequent wider use, including piloting and testing in non-specialist palliative care settings, two concerns were raised. First, in some non-specialist settings respondents didn’t want to use the word palliative, so the title was changed to the “Patient Outcome Scale”. This change to the title can be made for any version of POS (v1,v2, POS-S) and does not affect the validity of the questionnaire.
Second, there were concerns with question 7, which asks if the respondent felt life was worthwhile. Although this question is found in other longer questionnaires (e.g. the McGill Quality of Life Index) some staff did not like asking it and suggested that it would be more clinically useful to ask about depression.
POS v2 was therefore developed, with question 7 amended.
Depression can be examined more closely in POS v2, and question 7 can help to screen for depression (probably in association with the response to question 8: "do you feel good about yourself"). A trigger has also been added to make sure that when patients are filling in the POS themselves that they report scores of three or higher to their healthcare practitioner.
Should I use POS v1 or POS v2?
The decision should be made depending on the culture the organisation or setting you are working in, and your measurement requirements. POS v2 is now becoming the most commonly used version, because of the need to screen for depression.
However in some cultures it is not acceptable to admit that a person feels that they are depressed, and so POS v1 may be useful. If a patient says they feel that life is not worthwhile, they should screen for depression. In our evaluation of POS both versions of question 7 get similar ratings. The scores of the two versions are correlated.
Currently, some translations are only currently available in POS v1. Clearly it is important to know what version you are using.
Is there a difference in who can complete POS v1 or POS v2?
Both versions can be completed by: the patient (self-completion); healthcare staff; or the patient's carer/family. The questions are slightly modified for the different respondents.
IPOS is an exciting development, integrating the best of
POS,
POS-S and the
APCA African POS. It has been welcomed by patients and professionals as a more streamlined measure which is brief, yet which still captures their most important concerns - both in relation to symptoms, but also extending to information needs, practical concerns, anxiety or low mood, family anxieties, and overall feeling of being at peace.
The POS Symptom list (
POS-S) comprises 10 symptoms and two open questions. It can be used alongside POS to capture more information about symptoms, and is especially useful where a patient has multiple symptoms.
Use of POS-S is triggered if question 2 in POS (symptom control) suggests that the patient has multiple or problematic symptoms. POS-S can also be used on its own, if only a symptom assessment is required. However, problems in palliative care are usually multidimensional, so a broader assessment is often needed.
POS-S can be used for a range of conditions, e.g. cancer, heart failure, and respiratory conditions. Extended versions have also been developed for use with those living with multiple sclerosis, Parkinson’s disease and end-stage renal disease.
The MyPOS - a myeloma-specific version of the Palliative care Outcome Scale - has been developed and undergone preliminary validation. The questionnaire measures myeloma-specific quality of life issues and is intended for use in clinical care. The questionnaire development was funded by Myeloma UK and St Christopher's Hospice. Myeloma UK wanted a more specific measure that reflects upon what is particularly important to quality of life for people affected by myeloma.
The questionnaire was developed on the basis of an extensive systematic literature review, semi-structured qualitative interviews and focus groups. The preliminary version was tested via cognitive interviews and then further validated in a large national sample of 380 people with myeloma of different disease stages. Preliminary validation showed that the MyPOS reflects quality of life, is reliable and valid, and is able to distinguish between subgroups of people, i.e. those on and off treatment and those with high or low performance status.
C-POS:UK is being developed especially for children and young people with a variety of life-limiting and life-threatening conditions. The short tool measures symptoms and concerns of these children and young people and those of their families, and is intended for use in clinical care, and will also be useful for research studies.
The development of C-POS:UK began following systematic literature review that identified there was no ideal measure for use with this varied population. A robust development process is being followed including qualitative interview study, systematic review on how to best involve children and young people, survey to prioritise topics to include, and an expert meeting to develop measure items. The preliminary version was tested and refined via cognitive interviews. It is currently being validated in a large national study and will not be available for use until this robust work has concluded.
The C-POS:UK team are committed to a global community of C-POS users.
If you are already registered, you can update your profile
here. (Click on "The C-POS:UK (Children's POS:UK) is not yet available" to expand that section.) If you have any problems updating your profile please email .
