• Richard J Siegert, Wei Gao, Frank H Walkey, and Irene J Higginson.
• King's College London, Department of Palliative Care, Policy and Rehabilitation, School of Medicine at Guy's, King's College and St. Thomas' Hospitals, King's College London, London, United Kingdom. richard.siegert@kcl.ac.uk
• J Pain Symptom Manage. 2010 Jul 1;40(1):67-74.

ContextThe Palliative Care Outcome Scale (POS) is a widely used outcome measure in palliative care research, and has good psychometric properties. It has been used for clinical or research purposes in specialist cancer centers, nursing homes, day hospice units, and hospice settings in a growing number of countries. However, the POS has not yet been examined using factor analysis.ObjectiveThe aim of the present study was to examine the internal factor structure of the POS.MethodsConfirmatory and exploratory factor analyses were used for secondary analysis of two existing POS data sets of British patients, most of whom were cancer patients.ResultsWe began with a confirmatory factor analysis (CFA), which indicated that the POS is not a unidimensional scale. This was followed by an exploratory factor analysis that suggested two factors-one reflecting a psychological well-being dimension and the other consisting of three items relating to the standard of professional care. A similar two-factor structure also was identified in the second sample using CFA.ConclusionThe POS appears to capture two factors, psychological status and quality of care, and to have three items that function independently (family anxiety, symptoms, and pain control). Our findings suggest that future evaluations of palliative care services should include assessment not only of symptoms and well-being or quality of life, but also of quality of care, and that unidimensional measures will not capture all relevant aspects in palliative care.Copyright 2010 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

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