# Validity of scoring system for palliative care in oncology: CODETM – “Care of the dying evaluation”. Is it important in assessing the end-of-life process?

## TL;DR

The CODETM questionnaire is a useful tool for evaluating palliative care quality in hospitals, showing no significant differences between two hospitals but highlighting better care in wards and ICU.

## Contribution

The study validates the CODETM questionnaire as a practical tool for assessing and improving palliative care in public hospitals.

## Key findings

- The CODETM questionnaire showed higher scores in wards and ICU compared to emergency units.
- A predictive cut-off value of 78.6% was identified for adequate palliative care practice.
- Caregivers' perceptions of care quality did not differ significantly between the two hospitals.

## Abstract

Patients with advanced cancer experience a range of distressing symptoms. Palliative care (PC) emerges as an essential area to be implemented by health systems in the care of patients with irreversible diseases and beyond therapeutic possibilities.

To compare the perception of caregivers of patients in palliative care offered by two public hospitals using the CODETM questionnaire; to determine the score obtained by the questionnaire and its usefulness in the evaluation of the palliative care offered.

The post-death questionnaire “Care of the Dying Evaluation” (CODETM) was applied to the family members who accompanied the patients in the last days, assessing the perception of the quality of care provided to the patient and the level of support to the family.

No statistical difference in demographics. Participants who received palliative care had higher scores in the score, as well as in the ward and ICU unit compared to the emergency unit. The predictive cut-off value for adequate palliative care practice was 97 points, corresponding to 78.6% of the score.

There was no statistical difference between the caregivers’ perception of the care offered to patients between the two hospitals, being worse in the emergency unit. The cut-off value was 78.6% and was considered adequate and the CODETM questionnaire was a useful tool in the evaluation of palliative care offered by hospitals to patients and can be applied to propose improvements in palliative care. Therefore, there is a need for an instrument that can constantly classify and qualify the care provided to patients and their families in order to offer dignified, comprehensive and humanized care, as proposed by the CODETM questionnaire

Patients with advanced cancer experience a range of distressing symptoms.Palliative care is emerging as a key area for healthcare systems to innovate in assisting patients with irreversible diseases beyond therapeutic possibilities.Is an evaluation of palliative care provided at the end of life to SUS patients by public health institutions necessary? The answer is yes.For this evaluation, the CODE™ (Care of the Dying Evaluation) post-death questionnaire was administered to family members who accompanied patients in their final days of life, assessing their perception of the quality of care provided to the patient and the level of support provided to the family.The CODETM questionnaire was a useful tool in evaluating the palliative care offered by hospitals to patients and can be applied to propose improvements in palliative care.

Patients with advanced cancer experience a range of distressing symptoms.

Palliative care is emerging as a key area for healthcare systems to innovate in assisting patients with irreversible diseases beyond therapeutic possibilities.

Is an evaluation of palliative care provided at the end of life to SUS patients by public health institutions necessary? The answer is yes.

For this evaluation, the CODE™ (Care of the Dying Evaluation) post-death questionnaire was administered to family members who accompanied patients in their final days of life, assessing their perception of the quality of care provided to the patient and the level of support provided to the family.

The CODETM questionnaire was a useful tool in evaluating the palliative care offered by hospitals to patients and can be applied to propose improvements in palliative care.

Patients with advanced cancer often experience a number of distressing symptoms and face psychological, social, and spiritual problems, in addition to physical symptoms. The end-of-life process is one of the most significant moments for individuals, their family members and caregivers, representing an emotional overload with several consequences. Palliative care (PC) represents an essential service to be implemented by health systems to support patients with irreversible diseases and without therapeutic possibilities, with a focus on symptom control and improvement of quality of life, preventing and relieving human suffering in several dimensions, including the final period of an end-stage illness, in a moment of progressive decline that is inevitably approaching death. This study compares the perception of caregivers of patients in palliative care offered by two public hospitals using the CODETM questionnaire.

There is a need for an instrument that can constantly classify and qualify the care provided to oncological patients and their families in order to offer dignified, comprehensive and humanized care, as proposed by the CODETM questionnaire. There was no statistical difference between the caregivers’ perception of the care offered to patients between the two hospitals, being worse in the Emergency Unit.