The Integrated Palliative Outcome Scale (IPOS): A tool for assessing needs and shaping individualized care plans in hospice settings

OBJECTIVES: This mixed-method study examined whether the Integrated Palliative Outcome Scale (IPOS) can support the identification of palliative care needs and inform individualized care planning in hospice settings. METHODS: Thirty-eight terminally ill patients admitted to a hospice in Northern Italy completed the IPOS. Quantitative analyses described the frequency and intensity of physical, psychological, relational, spiritual, and practical needs at the first administration and, where available, compared scores across 2 administrations using non-parametric tests. Spearman correlations were used to explore associations between awareness of diagnosis/prognosis and symptom burden. In parallel, semi-structured interviews explored the subjective meaning of "being at peace with oneself"; responses were examined through thematic content analysis. RESULTS: IPOS administration highlighted frequent needs related to constipation, oral discomfort, weakness, drowsiness, anxiety, and concerns about family members. Awareness of diagnosis and prognosis were positively correlated. Anxiety and not feeling at peace showed negative associations with awareness, particularly awareness of prognosis. Across administrations, most physical symptoms remained stable, while anxiety and depressive feelings increased. Qualitative findings showed that inner peace was mainly associated with calmness, satisfaction with life, relational fulfilment, not having harmed others, and acceptance of one's condition. SIGNIFICANCE OF RESULTS: The integration of IPOS into routine hospice care may help multidisciplinary teams identify patients' evolving needs and translate them into more responsive individualized care plans. Combining structured IPOS scores with patient narratives can also make existential and psychosocial concerns more visible in clinical decision-making.