Cross-cultural adaptation of the POLST (physician orders for Life-Sustaining treatment) form

Abstract

In Brazil most health care professionals and institutions still have not included discussions about preferences of care at the end of life with patients with decreased life expectancy as part of their daily routine. This represents a major gap for the care at the close of life that is frequently associated with avoidable suffering of patients and their loved ones, and with waste of Public Health resources as well. In 1991 the Physician Orders for Life-Sustaining Treatment (POLST) program was started in the USA. It embodies a coordinated system to elicit, record and communicate patients' and families' preferences about life-prolonging treatments for individuals with decreased life expectancy across a variety of health care settings. Because of its objectivity and portability the POLST paradigm has spread across the USA and currently represents one of the most successful strategies to elicit and record preferences of care at the end of life in that country. Since there are not any similar instruments in Brazil, we propose the present study aimed at the cross-cultural adaptation of the POLST form to the Brazilian context. The cross-cultural adaptation methodology will follow the principles of good practice for the translation and cultural adaptation process recommended by the International Society for Pharmacoeconomics and Outcomes Research. The assessment of the measurement properties of the resulting Brazilian version of the POLST form will follow the recommendations of the Consensus based Standards for the selection of health Measurement INstruments (COSMIN). (AU)