The Relationship between Theory and Measurement in Evaluations of Palliative Care Services

Abstract

Studies to determine the effectiveness of palliative care services have been limited by difficulties in measuring relevant dependent variables. While reliabilities of various measures have been reported for terminally ill populations, the broader issue of whether such measures are sensitive to the effects of palliative care services has not been addressed. Such assessments are essential if the relative efficacy of alternative models of palliative care (for example, inpatient facilities versus consultation teams) are to be determined. This pilot study used a specific theoretical framework, Brickman's models of helping and coping, to assess three measures in a pretest / post-test design with 29 patients admitted to an established palliative care unit. Results indicated that only one measure, the Symptom Distress Scale, was both reliable and sensitive to the effects of the service. The results suggested that evaluations of palliative care services may be influenced by the extent to which measures are empirical indicators of the model of helping used within the setting.