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For free access to POS resources and to keep up to date with POS developments, please visit the new POS website http://pos-pal.org/
The POS represents a further development in outcome measures in palliative care, following STAS. It has 10 items, plus an open field for patient reports. It builds on some of the strengths of the STAS, such as clinical application and ease of use. It also addresses some of the weaknesses, such as integrating greater direct patient assessment and patient defined fields. It was validated in eight different settings, including hospital, community, in-patient hospice, outpatient, day care and general practice.
The POS was devised following a systematic review of outcome measures used in palliative care. This review concluded that there was a paucity of clinical questionnaires that could adequately reflect the holistic nature of palliative care (Hearn & Higginson, 1997). The POS was, therefore, designed to overcome some of the limitations associated with existing outcome measurement scales in palliative care. It evolved using a literature review of measures, work by a multi-professional project group with individuals who worked in different palliative care settings and a patient representative. The POS was then piloted in hospice, home, hospital and other community settings. The questionnaire covers: physical symptoms, psychological symptoms, spiritual considerations, practical concerns, emotional concerns and psychosocial needs.
There are two versions of the POS questionnaire, one for patients to complete the other for staff. Bringing together these two complementary perspectives allows the POS to identify patient's problems and enables staff to provide individualised care. It is a flexible tool, the usage of which can be determined by the needs of local services.
The POS showed acceptable validity when used in a variety of settings, such as, home care, hospice in-patient and day care and hospital inpatient care as well as outpatient and community services. It has also been shown to be a credible, clinical, research and audit tool, which is acceptable to both patients and staff (Hearn & Higginson, 1999). The POS can be used routinely to guide clinical practice and monitor service interventions. Moreover, the POS is a valuable audit tool that can help meet the current statutory requirements on clinical governance.