Preliminary study of the STAS scale adapted for use of children

Introduction. - Few tools exist, especially in children, to assess the quality of palliative care. The Support Team Assessment Schedule (STAS) scale, a multimodal evaluation of care by the health care team, developed and validated in 1990 by the Cicely Saunders Institute in London, is used in adults. A validated French translation is available since 1994. Objective. - The purpose of this preliminary study is to provide a tool adapted for the child.Method. - Adaptation of the STAS for use in children was made after a survey of 29 teams taking care of children in palliative care, taking into account the specificity of the paediatric population. Eleven of them have proposed adaptations. The feasibility of the administration of the questionnaire was tested on ten children by several teams. An adapted version of 16 items and questions about symptoms was produced and tested by the teams. Different opinions on the scale were collected and analysed.Results. - We present the adaptations made to the tool that was subjected to the analysis of different teams. The remarks following its use are also outlined.Discussion. - This scale seems interesting: it allows to scan a large portion of the field of palliative care, not to forget any field, to question and to improve care after determining some lines of work, to educate teams less accustomed to the practice of palliative care in children, especially at home, to consolidate a team around consistency of care, to define and adapt the care plan. The difficulties lie in the weightiness of this scale. Training in its use is essential and can shorten the time for filling the scale. The optimal pace for filling the scale probably varies from one child to another and depending on the evolution. Despite this, some aspects are not addressed, as the need for respite or the match between the place of care and the desire of the child or his/her family. Some ethical questions therefore remain unanswered.Conclusion. - The proposed tool has an interest to assess the quality of care performed by a team. Its use must remain an opportunity for singular dialogue and reflection as a team. (C) 2014 Elsevier Masson SAS. All rights reserved.