# Validation of the Turkish adaptation of FACETS-OF-PPC: a multidimensional outcome measure for pediatric palliative care

## TL;DR

This study validates the Turkish version of a multidimensional tool for measuring outcomes in pediatric palliative care, finding some reliable results but also areas needing improvement.

## Contribution

The Turkish adaptation and validation of the FACETS-OF-PPC for pediatric palliative care is presented.

## Key findings

- The Turkish version of FACETS-OF-PPC showed suboptimal model fit in confirmatory factor analysis.
- Internal consistency was adequate for 'normalcy' and 'caregiver competencies' but insufficient for other scales.
- Cultural differences and a small sample size may have affected the overall validity of the tool.

## Abstract

This study aims to validate the Turkish version of the Family-Centered Multidimensional Outcome Measure for Pediatric Palliative Care (FACETS-OF-PPC), originally developed in Germany for children with severe neurological impairments and their families.

The FACETS-OF-PPC was translated and culturally adapted following the World Health Organization's guidelines. Following expert reviews and pilot testing, the final version was completed and implemented between February and December 2021 at a pediatric palliative care center in Türkiye. Participants included family members and healthcare professionals closely involved with the patients. Exclusion criteria were age over 18, end-of-life stage, or non-Turkish speakers. Confirmatory factor analysis was conducted to evaluate the factorial validity.

The study analyzed 102 responses (51 parents, 51 healthcare professionals), revealing suboptimal model fit (X2/df = 2.29; CFI=0.805; TLI=0.757; SRMR=0.109; RMSEA = 0.114). Internal consistency was adequate for the "normalcy" (w = 0.87) and "caregiver competencies" (w = 0.86) scales, but insufficient for "child’s social participation" (w = 0.51), "social support" (w = 0.20), and "coping with the disease" (w = 0.50). While the Turkish version of FACETS-OF-PPC showed reliable results for certain dimensions, cultural differences and the small sample size likely affected the overall validity, suggesting the need for further refinement.