Abstract
A culturally appropriate person-centred approach is needed in Indian palliative care settings to address the holistic concerns most distressing for patients with cancer. The study aimed to evaluate the measurement properties of the Hindi Integrated Palliative Outcome Scale (IPOS), a person-centred tool to assess the physical, emotional, and care-related concerns of patients living with serious illness in resource-limited settings.This validation study was conducted with 240 adults living with cancer and receiving home-based palliative care services through CanSupport, a charitable organisation operating across Delhi and National Capital Region. Using consecutive sampling, participants completed the Hindi IPOS, EuroQol 5-Dimension 5-Level questionnaire (EQ-5D-5L), and demographic schedules through in-person interviews. Half of the participants completed two follow-up assessments at four to six week intervals. Participant recruitment and outcome assessments at baseline and the first follow-up were conducted in person by home-based palliative care teams. Due to COVID-19constraints, the second follow-up assessment for a small subset of participants (10 patients) was completed via video call. Measurement properties assessed included structural validity (exploratory and confirmatory factor analysis), internal consistency, test-retest reliability, construct validity, and responsiveness to change. Confirmatory factor analysis supported a three-factor structure (CFI = 0.845, RMSEA = 0.062, TLI = 0.794), aligning with the hypothesized model. Internal consistency was moderate to high for physical (α = 0.67) and emotional (α = 0.74) subscales, while the communication and quality of care subscale demonstrated low consistency (α = 0.35). Construct and known-groups validity were supported by associations with EQ-5D-5L and cancer stage (p < 0.001). The physical subscale detected meaningful changes over time. Open-text responses provided insight into unaddressed symptoms and psychosocial needs. IPOS Hindi is a valid, reliable, and culturally appropriate tool to assess palliative care needs in patients with advanced cancer. It supports person-centred care and can inform policy and practice of palliative care delivery.