Palliative Care

Palliative care is a relatively new field, and robust evaluations have been limited. In the past, such evaluations have also been weakened by inappropriate or insensitive measures of benefit, such as the outcome of care and quality of life. To set standards of care we need appropriate tools to measure quality of life outcomes and evidence about the most effective models of care.
 
The department has been active in developing measures in palliative care, principally:

• POS - Palliative care Outcome Scale
• STAS - Support Team Assessment Schedule

Rehabilitation

Outcome measurement is also important in rehabilitation. Since 1995, Prof Turner-Stokes has spear-headed a drive to develop common language outcome measurement for brain injury rehabilitation in the UK. A common strand for much of the recent work is the development of outcome measures with which to assess the effectiveness of rehabilitation intervention, and exploration of the relationship between different measures in current use in the UK. Evidence has been presented which clearly demonstrates that rehabilitation is not only effective, but also highly cost-effective in patients with severe complex disabilities following acquired brain injury.
 
Over nine years we have built up unique experience in the application, computerisation and statistical handling of outcome data. Specific outcome measures that we have developed and applied in the area of complex disability include:

• ArMA - ArM Activity measure
• CNA - Care Needs Assessment
• FIM+FAM Function Assessment Measure
• GAS - Goal Attainment Scaling

Many of the patients we see in rehabilitation have cognitive and communicative deficits following brain injury. This patient group often has difficulty in completing questionnaires or reporting symptoms such as pain and depression. Our projects have therefore involved development and evaluation of several original assessment tools adapted for disabled individuals including:

• DISCs - the Depression Intensity Scale Circles
• SPIN - the Scale of Pain INtensity
• the AbilityQ –a screening tool to assess ability to complete a questionnaire in the first place 
• the ShoulderQ – a tool for assessing timing and severity of shoulder pain in patients with cognitive and/or communicative deficits