Translation and cultural adaptation of IPOS (integrated palliative care outcome scale) in Estonia.

BACKGROUND: Patient Reported Outcome Measures (PROMs) are questionnaires that could be used in palliative care (PC) to evaluate patient well-being and monitor their care. PROMs enable a focus on what is important to patients by putting the patient at the center of care. Adapting an existing PROM requires considering cultural differences, general usability and understandability of translated terms. AIM: To translate and culturally adapt both the patient and staff three and seven day versions of the Integrated Palliative care Outcome Scale (IPOS) into Estonian. The IPOS consist of 10 questions (staff versions 9 questions) and 17 close ended items. The sub aim is to describe the differences and discrepancies found during the adaptation process and compare the results with previous research. METHODS: The translation and adaptation process of IPOS was conducted using recommended guidelines consisting of six phases and included cognitive interviews with patients (n = 11) and palliative care multidisciplinary team members (n = 8). The study was conducted in two major Estonian hospitals. RESULTS: The Estonian IPOS demonstrated face and content validity, acceptance by patients and staff. As a result of expert group review and cognitive interviews with patients and staff, 9 semantic changes were implemented. CONCLUSIONS: Patient and staff versions of the IPOS with a recall of 3 or 7 days were translated and culturally adapted for Estonia. The Estonian IPOS four versions are ready for use in Estonia.

Recording of dynamic arterial compliance changes during hand elevation.

Finger arterial compliance has been studied on the beat-to-beat basis by using the digital arterial pressure and volume waveforms and performing measurements at zero transmural pressure during arm elevation in 11 volunteers. Continuous non-invasive finger blood pressure was measured by applying the Finapres monitor and the finger volume pulses were recorded by the UT9201 physiograph by using the photoplethysmographic principle of registration. Estimation of the beat-to-beat finger arterial compliance is based on (i) the recorded volume and pressure wave amplitudes (Vpulse and Ppulse) and (ii) on the calculation of the slope of the pressure-volume relationship from the first derivatives dV/dt and dP/dt of the recorded volume and pressure pulses near the point of the maximum slope. The results of the study demonstrate that the applied two methods similarly (correlation coefficient r = 0.97) describe the changes of the beat-to-beat compliance during hand elevation test. At the same time the second estimate was 18% higher than the first one (P = 0.003).