Begin at the left column and read downward until the appropriate ambulation level is. The pps was developed before the field of palliative care had established a widespread presence in the outpatient setting. The palliative care quality of life instrument incorporates six multiitem and one singleitem scale. Although there is a growing body of knowledge on survival prediction in populations with advanced cancer receiving palliative care using the palliative performance scale pps, this literature has focused on disease, gender, and care location, and less is known about how to apply such knowledge to be clinically meaningful. The palliative performance scale ppsv2 version 2 is a. Palliative performance scale central lhin hospice palliative care. The egss survey is designed to evaluate grief support services from the perspective of the recipients of the services. Palliative care criteria consider the following criteria when determining the palliative care score of this patient 1.
Pdf the palliative performance scale pps, a modification of the karnofsky performance scale, is presented as a new tool for measurement. The palliative performance scale pps palliative care. Palliative performance scale pps description the palliative performance scale is a reliable and valid tool used for assessing a patients functional status. Validation of the palliative performance scale for. Score the residents palliative performance scale pps as indicated by referring to the victoria hospice. Using the palliative performance scale to provide meaningful.
Correlation between braden scale and palliative performance scale in advanced illness. The value of the palliative performance scale youtube. These steps are repeated until all five columns are covered before assigning the actual pps for that patient. This can be used to compare effectiveness of different therapies and to assess the prognosis in individual patients. The pps uses five observerrated domains correlated to the karnofsky performance scale. Palliative performance scale pps version 2 nursing. The palliative performance scale pps is a modification of the karnofsky performance scale kps, designed specifically for measurement of physical status in palliative care table 2 2. Use of the palliative performance scale version 2 in.
Begin at the left column and read downward until the appropriate ambulation level is reached. Abstract this study describes the significant correlation between the braden scale bs and the palliative performance scale pps in patients with advanced illness that has not been previously. Advanced age is commonly marked by increased cancer risk, chronic disease, comorbidities, the complexity of dementia, and increasing frailty. Stroke with palliative performance scale pps palliative performance scale version 2 ppsv2 tool is to victoria hospice society and replaces the first pps published in 1996 j pall care 94. Utilization of the scale provides succinct reporting of a patients performance. The palliative performance scale pps has been used as a tool for measurement of functional status in palliative care. The palliative performance scale pps is a modification of the karnofsky performance scale kps, designed specifically for measurement of physical status in palliative care table 2. The palliative performance scale pps is a valid, reliable functional. Using the palliative performance scale, only about 10% of patients with a score of 50% or less would be expected to survive more than 6 months. Begin nursing guidelines for endoflife care within one week of admission for all residents. This study explores the application of the pps as a tool for projecting length of stay until death or discharge in a homebased hospice program.
Predicting survival with the palliative performance scale in. Palliative care criteria consider the following criteria. Although this patient may be placed in a wheelchair and perhaps seem initially to be at. The average time required to complete the questionnaire. Pdf use of palliative performance scale in endoflife. The palliative performance scale was developed by victoria hospice and used to measure performance status in palliative care. The pap uses the karnofsky performance score kps and five other criteria to generate a numerical score from 0 to 17. Background accurate prognostic information is vital for patients, families and clinicians.
Palliative performance scale version 2 ppsv2 has been widely utilized across palliative care patient populations, yet limited data are available on its prognostic value in patients with heart failure. Journal of palliative care 121, 511 % ambulation activity and evidence of disease selfcare intake conscious level 0 death 10 totally bedbound unable to do any work, extensive disease. Pps was developed by victoria hospice society, british columbia. Palliative care appropriate screening tool section 1 diagnosis.
There is a range of tools to assist with overall patient. Using the palliative performance scale to estimate. The pps is divided into 11 categories that are measured in 10% decremental stages 100% to 0%. The palliative performance scale collaborativecurriculum. Performance statussymptoms partial score palliative performance scale 1020 4 3050 2. Palliative care nurse practitioner symptom assessment guide. Use of the palliative performance scale to estimate.
Use of the palliative performance scale version 2 in obtaining palliative care consults. Palliative performance scale ppsv2 use of the pps ppsv2 allows common language about performance status that is relevant in hospice and palliative care. The palliative performance scale pps is a useful tool for measuring the progressive decline of a palliative resident. The palliative performance scale pps, which incorporates five observerrated parameters ambulation, activity and evidence of disease, selfcare, intake, and level of consciousness has been developed as a novel modification of the karnofsky performance scale for measuring performance status in palliative care, allowing for the evolving. To address this issue, we evaluated a database comprising years of. Michael downing, md, director of research at victoria hospice, talks with virtual hospice about the advantages of using the palliative performance scale to facilitate communication between. Pps scores are determined by reading horizontally at each level to find a best fit for the patient which is then assigned as the pps%. A patient who has become paralyzed and quadriplegic requiring total care would be pps 30%.
A reliability and validity study of the palliative performance scale. Palliative performance scale pps and palliative care conferences. Scroll to the bottom for more detailed information. Peas the physicians endoflife care attitude scale pnpc problems and needs in palliative care instrument pnpcsv short version of the problems and needs in palliative care questionnaire poms profile of mood states pos palliative care outcome scale pps palliative performance scale pqli palliative care quality of life instrument. Schotsman, and natasha laroque, for the quality palliative care in long term care alliance qpcltc. Palliative care nurse practitioner symptom assessment guide 5 using the sag each symptom has been presented according to the following format. Approach to symptom assessment in palliative care uptodate.
The pps is a reliable and valid tool and correlates well with actual survival. Functional assessment scale fast palliative performance scale pps functional assessment scale fast a hospice is a program designed to care for the dying and grams should include. The palliative performance scale pps, a modification of the karnofsky performance scale, is presented as a new tool for measurement of physical status in palliative care. Palliative performance scale pps scores have shown potential for prognosticating survival in predominately caucasian samples, but have not been studied for prognostic value in cancer patients from racial and ethnic minority groups. The palliative prognostic score palliative care network. A reliability and validity study of the palliative. Palliative prognostic index ppi the ppi relies on the assessment of performance status using the palliative performance scale pps, oral intake, and the presence or absence of dyspnea, edema, and delirium. Guideline for estimating length of survival in palliative. A performance status is a global measure of a patients functional capacity and has been shown to predict survival in patients near the end of life. Performance status scale grade scale 1 fully active able to carry on all predisease activities without restriction. Palliative care for the patient with incurable cancer or advanced disease part 1.
The palliative performance scale pps is a useful tool for measuring the progressive decline. Palliative performance scale pps 1 palliative performance. Its initial uses in victoria include communication, analysis of home nursing care workload, profiling admissions and discharges to the hospice unit, and, possibly. Palliative performance scale pps 100 full normal activity, no evidence of disease 90 full normal activity, no evidence of disease normal activity 80 full with effort, some evidence of disease unable to do 70 reduced normal work, some evidence of disease unable to do 60 reduced hobbies or some housework, some evidence of disease.
Scott wilner, md and robert arnold, md the palliative performance scale pps uses five observerrated domains correlated to the karnofsky performance scale. However, it does not take the place of a physicians professional judgment. Palliative performance scale ppsv2 hospice palliative care. The palliative performance scale pps 1 can help clinicians to recognize a patients. Palliative performance scale pps 2 gentiva health services, inc. Many patients in the ed may benefit from pc screening and referral. The questionnaire was completed at baseline and oneweek after. Worldwide the population of older adults is growing at unprecedented rates institute of medicine, 2009. Palliative performance scale % ambulation activity and evidence of disease selfcare intake conscious level 100 full normal activity no evidence of disease full normal full 90 full normal activity some evidence of disease full normal full 80 full normal activity witheffort some evidence of disease full normal or reduced full. Use of the palliative performance amazon web services. Palliative performance scale pps and palliative care. Relief from suffering may be found in services provided by palliative care. The palliative performance scale pps medical care of the dying, 4th ed p. Background accurate prognostic information is important for patients, families and physicians.
This study evaluated the reliability and validity of pps. Approach to care 2017 will enhance quality of life, and may also positively influence the course of illness. The lower the karnofsky score, the worse the survival for most serious illnesses. Palliative care screening and assessment in the emergency. Definition causes important points assessment physical examinationination diagnostic points. Correlation between braden scale and palliative performance. Patients diagnosed with incurable cancer or advanced disease may not identify themselves as requiring palliative care.
Palliative care is specialty level, interdisciplinary care that includes active, total care of patients whose disease is not responsive to curative treatment. Several different performance status metrics have been developed to quantify performance status, and among them, the karnofsky performance status kps is the most often used. View the article pdf and any associated supplements and figures for a period of 48 hours. Implementing the integrated palliative care outcomes scale 2 overview new york state department of health recently issued a change to the dsrip palliative care project 3. Yet, their findings are different in terms of the presence of distinct pps survival profiles and significant covariates. The palliative performance scale ppsv2 version 2 consultgeri. Can not compute because not all questions was answered. The palliative performance scale pps was first introduced in1996 as a.
Palliative performance scale pps the palliative performance scale pps is a validated and reliable tool used to assess a patients functional performance and to determine progression toward end of life. The karnofsky performance scale index allows patients to be classified as to their functional impairment. The condensed collaborative care plans ccps are a quick reference tool for healthcare providers to use when developing care plans for cancer patients. Emergency department ed providers and policy makers are increasingly interested in developing palliative care pc interventions for ed patients. Palliative care for the patient with incurable cancer or.
The most commonly used are the karnofsky performance status scale see table 1 and ecog scale. Painad pain assessment scale resp distress observation scale revised edmonton symptom assessment scale karnofsky performance status scale ecog performance scale predictors of survival principles of risk management during opioid treatment for pain causes of dyspnea in palliative care patients borg scale clinical copd. Multiple edbased pc screening projects have been undertaken, but there has been no study of these projects or their effects. The palliative performance scale ppsv2 version 2 is a communication tool for quickly describing a persons current functional level. Cleary, dnp, gnpbc, chpn,transitions lifecare, raleigh, north carolina why. Newer scales, such as the palliative prognostic score and the palliative performance scale. However, it does not take the place of a physicians.
A webbased, case scenarios study with a testretest format was used to determine reliability. Mar 08, 2015 this video describes what the pps is and how to use it. The palliative performance scale pps was first introduced in1996 as a new tool for measurement of performance status in palliative care. Use of palliative performance scale in endoflife prognostication article pdf available in journal of palliative medicine 95. In this way, leftward columns columns to the left of any specific column. The palliative performance scale pps has been widely used for survival prediction among patients with cancer. Michael downing, md, director of research at victoria hospice, talks with virtual hospice about the advantages of using the palliative performance scale to. Programs may use ppsv2 with appropriate recognition. The palliative performance scale pps has been shown to be both valid and useful for a broad range of palliative care patients. Performance scales can help physicians, families of pediatric.
The ppsv2 allows more common language about performance status than the karnofsky performance scale. This paper describes the development of a new quality of life instrument in advanced cancer patients receiving palliative care. Unfortunately, predicting survival is not easy, even after admission to hospice or palliative care programs. Aug 04, 2008 the palliative performance scale pps was first introduced in1996 as a new tool for measurement of performance status in palliative care. The palliative performance scale version 2 is a prognostication tool that can help overcome this barrier. The palliative care quality of life instrument pqli in. Pps has been used in many countries and has been translated into other languages. The palliative performance scale pps medically speaking. Palliative performance scale ppsv2 functional assessment. Palliative performance scale pps adapted from anderson, fern et al. It cannot be altered or used in any way other than as intended and described here. The palliative performance scale version 2 ppsv2 tool is to victoria hospice society and replaces the first pps published in 1996 j pall care 94. The palliative performance scale pps is a tool for measurement of performance status in palliative care. There are reported studies in which the palliative performance scale pps is used as a prognostic tool to predict survival of these patients.