This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Steel, K. Articles by Fries, B. E. Search for Related Content PubMed PubMed Citation Articles by Steel, K. Articles by Fries, B. E. Social Bookmarking                         What's this?

The RAI-PC: An assessment instrument for palliative care in all settings

Hackensack University Medical Center, Hackensack, and UMDNJ/New Jersey Medical School, Newark, New Jersey

G. Ljunggren, MD

Centre for Gerontology and Health Economics, Stockholm, and Neurotec, Karolinska Institute, Stockholm, Sweden

E. Topinková, MD, PhD

Charles University Prague and Institute of Postgraduate Medical Education, Prague, Czech Republic

J. N. Morris, PhD, MSW

The Hebrew Rehabilitation Center, Boston, Massachusetts

C. Vitale, MD

St. Vincent’s Hospital, New York, New York

J. Parzuchowski, RN, MS

The Hospice of Michigan, Detroit, Michigan

S. Nonemaker, RN, MS

The Hebrew Rehabilitation Center, Boston, Massachusetts

D. H. Frijters, PhD

Free University Medical Centre, Amsterdam, the Netherlands

T. Rabinowitz, MD

University of Vermont College of Medicine, Burlington, Vermont

K. M. Murphy, RN, PhD

The Hebrew Rehabilitation Center, Boston, Massachusetts

M. W. Ribbe, MD

Institute for Research in Extramural Medicine, Vrije University Medical Center, Amsterdam, the Netherlands

B. E. Fries, PhD

Institute of Gerontology and School of Public Health, University of Michigan, and Ann Arbor VA Medical Center, Ann Arbor, Michigan

Large numbers of persons in most types of healthcare settings have palliative care needs that have considerable impact on their quality of life. Therefore, InterRAI, a multinational consortium of researchers, clinicians, and regulators that uses assessment systems to improve the care of elderly and disabled persons, designed a standardized assessment tool, the Resident Assessment Instrument for Palliative Care (RAI-PC). The RAI-PC can be used for both the design of individual care plans and for case mix and outcomes research. Some elements of this instrument are taken from the resident assessment instrument (RAI) mandated for use in all nursing homes in the United States and widely used throughout the world. The RAI-PC can be used alone or in conjunction with the other assessment tools designed by the InterRAI collaboration: the RAI for homecare (RAI-HC), for acute care (RAI-AC), and for mental health care (RAI-MH).

The objective of this study was to field test and carry out reliability studies on the RAI-PC. After appropriate approvals were obtained, the RAI-PC instrument was field tested on 151 persons in three countries in more than five types of settings. Data obtained from 144 of these individuals were analyzed for reliability. The reliability of the instrument was very good, with about 50 percent of the questions having kappa values of 0.8 or higher, and the average kappa value for each of the eight domains ranging from 0.76 to 0.95. The 54 men and 95 women had a mean age of 79 years. Thirty-four percent of individuals suffered pain daily. Eighty percent tired easily; 52 percent were breathless on exertion; and 19 to 53 percent had one or more other symptoms, including change in sleep pattern, dry mouth, nausea and vomiting, anorexia, breathlessness at rest, constipation, and diarrhea. The number of symptoms an individual reported increased as the estimated time until death declined. The "clinician friendly" RAI-PC can be used in multiple sites of care to facilitate both care planning and case mix and outcomes research.

Key Words: RAI-PC • InterRAI • palliative care • pain

American Journal of Hospice and Palliative Medicine®, Vol. 20, No. 3, 211-219 (2003)
DOI: 10.1177/104990910302000311


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				G. Albers, M. A Echteld, H. C. de Vet, B. D Onwuteaka-Philipsen, M. H. van der Linden, and L. Deliens Evaluation of quality-of-life measures for use in palliative care: a systematic review Palliative Medicine, January 1, 2010; 24(1): 17 - 37. [Abstract] [PDF]

				M. Hjermstad, J Gibbins, D. Haugen, A Caraceni, J. Loge, S Kaasa, and On behalf of the EPCRC, European Palliative Care R Pain assessment tools in palliative care: an urgent need for consensus Palliative Medicine, December 1, 2008; 22(8): 895 - 903. [Abstract] [PDF]

				E. Jakobsson, F. Gaston-Johansson, J. Ohlen, and I. Bergh Clinical problems at the end of life in a Swedish population, including the role of advancing age and physical and cognitive function Scand J Public Health, March 1, 2008; 36(2): 177 - 182. [Abstract] [PDF]

				M. S. Jordhoy, G. Inger Ringdal, J. L. Helbostad, L. Oldervoll, J. H. Loge, and S. Kaasa Assessing physical functioning: a systematic review of quality of life measures developed for use in palliative care Palliative Medicine, December 1, 2007; 21(8): 673 - 682. [Abstract] [PDF]

				C. Saxby, R. Ackroyd, S. Callin, C. Mayland, and S. Kite How should we measure emesis in palliative care? Palliative Medicine, July 1, 2007; 21(5): 369 - 383. [Abstract] [PDF]

				M. A Echteld, L. Deliens, M. E Ooms, M. W Ribbe, and G. van der Wal Quality of life change and response shift in patients admitted to palliative care units: a pilot study Palliative Medicine, July 1, 2005; 19(5): 381 - 388. [Abstract] [PDF]