Adaptation of the Taiwan Version of the Supportive and Palliative Care Indicators Tool (SPICT-TW) and Its Association with Six-Month Mortality: A Multi-Center Validation Study in Older People

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Abstract
Background: The Supportive and Palliative Care Indicators Tool (SPICT) was developed for identifying, in a timely manner, patients who may benefit from supportive and palliative care for better treatment review, care-plan discussion, and end-of-life care. Although the SPICT has been validated in different languages and for patients living in different settings, it has not been validated for patients receiving home-based medical care (HBMC), or in the context of using traditional Chinese characters. Objectives: The present study aimed to validate the Taiwanese version of the SPICT (SPICT-TW) and to measure its ability to predict six-month mortality in patients who received HBMC in Taiwan. Methods: Seven HBMC agents (five clinics and two hospitals) participated in this validation study. We recruited 129 patients aged ≥ 50 years who had been consistently receiving HBMC for >two months. Results: The results revealed that the SPICT-TW demonstrated similar reliability and validity compared to other language versions of the SPICT. It may be an appropriate tool for healthcare professionals to detect, in a timely manner, the needs for palliative care in older people who receive home healthcare. Furthermore, we found that a combination of four general indicators and one clinical indicator in the SPCIT-TW has the best prediction ability at predicting six-month mortality in these HBMC recipients. This multi-center study validated the SPICT-TW among HBMC recipients in Taiwan. Conclusions: The SPICT-TW demonstrated high reliability and validity through the Kuder–Richardson 20, an intraclass correlation coefficient, Cohen’s kappa, and receiver operating characteristic analysis, supporting its potential as a practical tool for identifying older adults at risk of dying within six months who have not yet received palliative care but may benefit from it.
Funding Information
  • National Health Research Institutes (PH-108-GP-04, PH-109-GP-04, 112-2410-H-037-005-MY3, KMUH112-2R77)
  • National Science and Technology Council of Taiwan (PH-108-GP-04, PH-109-GP-04, 112-2410-H-037-005-MY3, KMUH112-2R77)
  • Kaohsiung Medical University Chung-Ho Memorial Hospital (PH-108-GP-04, PH-109-GP-04, 112-2410-H-037-005-MY3, KMUH112-2R77)

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