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Turkish Adaptation of the Supportive and Palliative Care Indicators Tool (SPICT): A Validity and Reliability Study
Çetin ÖK, Ileri H, Öztürk YK.. Research Square, 2026-07-06
Topic: Health services, long-term care and technology
Background One of the major challenges in clinical practice in Türkiye is the lack of objective criteria for the early identification of patients requiring palliative care. The Supportive and Palliative Care Indicators Tool (SPICT™), developed by Murray SA and colleagues and updated in 2025, is an internationally recognized clinical decision-support tool designed to systematically identify deteriorating health and unmet palliative care needs. This study aims to evaluate the validity and reliability of the Turkish version of the SPICT (SPICT-TR). Methods This descriptive and methodological study was conducted through face-to-face interviews involving 24 physicians and 356 patients. The linguistic adaptation process followed the Beaton protocol and the five-stage translation and cultural adaptation guidelines recommended by the World Health Organization. The data collection form consisted of two sections: sociodemographic information of physicians and patients, and the SPICT-TR along with the "Surprise Question/Reverse Surprise Question." Data were analyzed using descriptive statistics, Chi-square, and Chi-square Exact tests. Internal consistency was evaluated using the Kuder–Richardson 20 (KR-20) coefficient, and inter-rater reliability was assessed using Cohen’s Kappa coefficient. Results The mean age of the 356 patients included in the study was 70.7 ± 11.5 years, with the majority of the sample consisting of patients with multimorbidity. The internal consistency coefficient was found to be KR-20 = 0.87, and the agreement with physicians' clinical assessments was Cohen’s Kappa = 0.93 (p < 0.001). Patients identified as needing palliative care according to SPICT-TR had a significantly higher rate of hospitalization within the last month (p < 0.001). A strong correlation was found between SPICT-TR and Surprise Question responses; specifically, the accuracy of mortality prediction was significant in dementia and malignant diseases (p < 0.001). Conclusions The SPICT-TR is a culturally adapted, valid, and reliable assessment tool for identifying patients with palliative care needs within the Turkish healthcare system. Its high internal consistency and strong agreement with physician clinical judgment suggest that it can serve as a structured support tool in clinical practice. Integrating SPICT-TR into routine practice may contribute to earlier recognition of palliative care needs and timely care planning.
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APA 7th
ÖK, Ç., Ileri, H., & Öztürk, Y. K. (2026). Turkish Adaptation of the Supportive and Palliative Care Indicators Tool (SPICT): A Validity and Reliability Study. Research Square. https://doi.org/10.21203/rs.3.rs-9509550/v1
Vancouver
ÖK Ç, Ileri H, Öztürk YK. Turkish Adaptation of the Supportive and Palliative Care Indicators Tool (SPICT): A Validity and Reliability Study. Research Square. 2026. doi:10.21203/rs.3.rs-9509550/v1.
BibTeX
@article{ok2026-bee8ba1d,
author = {ÖK, Çetin and Ileri, H. and Öztürk, Y. K.},
title = {{Turkish Adaptation of the Supportive and Palliative Care Indicators Tool (SPICT): A Validity and Reliability Study}},
journal = {Research Square},
year = {2026},
doi = {10.21203/rs.3.rs-9509550/v1},
url = {https://doi.org/10.21203/rs.3.rs-9509550/v1}
}
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Key findings
- Results The mean age of the 356 patients included in the study was 70.7 ± 11.5 years, with the majority of the sample consisting of patients with multimorbidity.
- Patients identified as needing palliative care according to SPICT-TR had a significantly higher rate of hospitalization within the last month (p < 0.001).
- A strong correlation was found between SPICT-TR and Surprise Question responses; specifically, the accuracy of mortality prediction was significant in dementia and malignant diseases (p < 0.001).
- Its high internal consistency and strong agreement with physician clinical judgment suggest that it can serve as a structured support tool in clinical practice.
Study details
- Participants356
- Evidence strengthLow
How this study scored 16/100
Preprint — not yet peer-reviewed. It scored 29 on the same rubric, but non-peer-reviewed sources are capped at 16, so it shows as 16. Scored zero for study design, effect reported and randomised / blinded because the record does not state it. We have no data on times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 18 of the 62 points we could judge it on, which is 29 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 2 / 10 | Tier 4 — not a peer-reviewed journal (Research Square) |
| Journal's citation record | 0 / 4 | Not a journal article, so the journal's record does not count |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 4 / 10 | Preprint — not yet peer-reviewed. Hosted on a preprint server. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 2 / 4 | 356 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 18 / 62 | Scored on 12 of 20 parts. We have no data for the rest, so they are left out: 18 of the 62 points we could judge it on is 29 out of 100. |
| Total | 29 / 100 | Capped to 16 because this is not a peer-reviewed article. |
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