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STAS - Support Team Assessment Schedule

STAS is a popular measure and has been used extensively in the UK, across Europe, Canada, the USA, Australia, Asia and Africa. It has been used in a variety of settings, including home care, hospital, in the community, hospice, day care and general practice.

Background to STAS

The Support Team Assessment Schedule (STAS) was developed by Prof Higginson when based at University College London. The psychometric testing was presented in her PhD thesis. It is a unique tool that assess the clinical outcomes and intermediate outcomes of palliative care. Before STAS was developed there was no standard reliable, valid and responsive measure to assess palliative care: most existing measures had floor effects and did not reflect palliative care goals. STAS can be used in studies to compare palliative care services or in clinical audit. It has 9 core or up to 20 optional items covering physical, psychosocial, spiritual, communication, planning, family concerns and service aspects.

Further details are available in Clinical Audit in Palliative Care (ed. Higginson I) published by Radcliffe Medical Press.

Published papers on the Support Team Assessment Schedule
  • BAUSEWEIN C, Le Grice C, SIMON ST, HIGGINSON IJ, on behalf of PRISMA. The use of two common palliative outcome measures in clinical care and research: A systematic review of POS and STAS. Palliative Medicine 2011 [In press] DOI: 10.1177/0269216310395984
  • Butters E, HIGGINSON I. Two HIV/AIDS community support teams: patient characteristics, problems at referral and during the last 6 weeks of life. AIDS Care. 1995;7(5):593-603.
  • Butters E, HIGGINSON I, George R, Smits A, McCarthy M. Assessing the symptoms, anxiety and practical needs of HIV/AIDS patients receiving palliative care. Qual Life Res 1992 Feb;1(1):47-51.
  • Butters E, HIGGINSON I, George R, McCarthy M. Palliative care for people with HIV/AIDS: views of patients, carers and providers. AIDS Care 1993;5(1):105-16.
  • Carson MG, Fitch MI, Vachon ML. Measuring patient outcomes in palliative care: a reliability and validity study of the Support Team Assessment Schedule. Palliat Med 2000 Jan;14(1):25-36.
  • Chvetzoff G, Perol D, Devaux Y, Lancry L, Rebattu P, Magnet M, Dubost E, Bertrand M, Garcon C, Thevenet G, Gobet S, Arbiol E, Saltel P. [Prospective study on the quality of care and quality of life in advanced cancer patients treated at home or in hospital: intermediate analysis of the Trapado study]. Bull Cancer. 2006;93(2):213-21.
  • Cooper J, Hewison A. Implementing audit in palliative care: an action research approach. J Adv Nurs 2002 Aug;39(4):360-9.
  • EDMONDS P, HIGGINSON I, Altmann D, Sen-Gupta G, McDonnell M. Is the presence of dyspnea a risk factor for morbidity in cancer patients? J Pain Symptom Manage 2000 Jan;19(1):15-22.
  • EDMONDS PM, Stuttaford JM, Penny J, Lynch AM, Chamberlain J. Do hospital palliative care teams improve symptom control? Use of a modified STAS as an evaluation tool. Palliat Med 1998 Sep;12(5):345-51.
  • Fergus CJ, Nicol JS, Russell PB. Is a STAS-based tool valid to triage patients at a specialist palliative care inpatient unit? Int J Palliat Nurs 2008 Jan;14(1):24-9.
  • Francke AL. Evaluative research on palliative support teams: a literature review. Patient Educ Couns 2000 Aug;41(1):83-91.
  • Guell,E, Farinas,O, Ramos,A., Solis,R., Pascual,A. [Cancer pain in a palliative care unit]. Dolor 2009;24(1):21-27
  • HIGGINSON IJ, HEARN J. A multicenter evaluation of cancer pain control by palliative care teams. Journal of Pain and Symptom Management 1997;14 (1):29-35.
  • HIGGINSON I, McCarthy M. Measuring symptoms in terminal cancer: are pain and dyspnoea controlled? J R Soc Med 1989 May;82(5):264-7.
  • HIGGINSON I, McCarthy M. Evaluation of palliative care: steps to quality assurance? Palliative Medicine 1989;3:267‑74.
  • HIGGINSON I, Wade A, McCarthy M. Effectiveness of two palliative care support teams. Journal of Public Health Medicine 1992,14(1):50‑56.
  • HIGGINSON IJ, McCarthy M. Validity of the support team assessment schedule: do staffs' ratings reflect those made by patients or their families? Palliat Med 1993;7(3):219-28.
  • HIGGINSON IJ, McCarthy M. A comparison of two measures of quality of life: their sensitivity and validity for patients with advanced cancer. Palliat Med 1994 Oct;8(4):282-90.
  • HIGGINSON IJ, Wade AM, McCarthy M. Effectiveness of two palliative support teams. J Public Health Med 1992;14(1):50-6.
  • Hodgson C, HIGGINSON I, McDonnell M, Butters E. Family anxiety in advanced cancer: a multicentre prospective study in Ireland. Br J Cancer. 1997;76(9):1211-4.
  • Iwase S, Murakami T, Saito Y, Nakagawa K. Preliminary statistical assessment of intervention by a palliative care team working in a Japanese general inpatient unit. Am J Hosp Palliat Care 2007 Feb;24(1):29-35.
  • Krzyzanowski,D, Chybicka,A., Fal,A.M. [Comfort and mental condition assessment of patients affected by serious cognitive disorders and provided with palliative care]. Onkologia Polska 2008;11(4):141-144
  • Lagabrielle D, Guyot F, Jasso G, Couturier P, Poussin G, Frossard M, et al. [A French tool for evaluation of home palliative care: adaptation of the Support Team Assessment Schedule]. Sante Publique 2001 Sep;13(3):263-76.
  • Lo RS, Ding A, Chung TK, Woo J. Prospective study of symptom control in 133 cases of palliative care inpatients in Shatin Hospital. Palliat Med 1999 Jul;13(4):335-40.
  • McCarthy M, HIGGINSON I. Clinical audit by a palliative care team. Journal of Palliative Medicine 1991;5(3):215‑21.
  • Mess E, Kempinska E, Leppert W, Krzyianowski D. Assessment of quality of life, pain and effectiveness of treatment in palliative care patients. Rocz Akad Med Bialymst 2005;50 Suppl 1:207-9.
  • Miyashita M, Matoba K, Sasahara T, Kizawa Y, Maruguchi M, Abe M, et al. Reliability and validity of the Japanese version of the Support Team Assessment Schedule (STAS-J). Palliat Support Care 2004 Dec;2(4):379-85.
  • Miyashita M, Yasuda M, Baba R, Iwase S, Teramoto R, Nakagawa K, et al. Inter-rater reliability of proxy simple symptom assessment scale between physician and nurse: a hospital-based palliative care team setting. Eur J Cancer Care (Engl ) 2010 Jan 1;19(1):124-30.
  • Morita T, Fujimoto K, Namba M, Kiyohara E, Takada S, Yamazaki R, et al. Screening for discomfort as the fifth vital sign using an electronic medical recording system: a feasibility study. J Pain Symptom Manage 2008 Apr;35(4):430-6.
  • Morita T, Imura C, Fujimoto K, Shishido H, Tei Y, Inoue S. Changes in medical and nursing care in cancer patients transferred from a palliative care team to a palliative care unit. J Pain Symptom Manage. 2005 Jun;29(6):595-602.
  • Morita T, Takigawa C, Onishi H, Tajima T, Tani K, Matsubara T, Miyoshi I, Ikenaga M, Akechi T, Uchitomi Y; Japan Pain, Rehabilitation, Palliative Medicine, and Psycho-Oncology (PRPP) Study Group. Opioid rotation from morphine to fentanyl in delirious cancer patients: an open-label trial. J Pain Symptom Manage. 2005;(1):96-103.
  • Peruselli C, Di GP, Toscani F, Gallucci M, Brunelli C, Costantini M, et al. Home palliative care for terminal cancer patients: a survey on the final week of life. Palliat Med 1999 May;13(3):233-41.
  • Sasahara T, Miyashita M, Umeda M, Higuchi H, Shinoda J, Kawa M, et al. Multiple evaluation of a hospital-based palliative care consultation team in a university hospital: activities, patient outcome, and referring staff's view. Palliat Support Care 2010 Mar;8(1):49-57.
  • Shirayama H, Iuchi M, Asada H, Yokoi H, Fujita T. [The influence of family willingness to home palliative care]. Gan To Kagaku Ryoho. 2006;Suppl 2:341-4.
  • Tei Y, Morita T, Nakaho T, Takigawa C, Higuchi A, Suga A, et al. Treatment efficacy of neural blockade in specialized palliative care services in Japan: a multicenter audit survey. J Pain Symptom Manage 2008 Nov;36(5):461-7.
  • Tsai LY, Li IF, Liu CP, Su WH, Change TY. Application of quality audit tools to evaluate care quality received by terminal cancer patients admitted to a palliative care unit. Support Care Cancer 2008 Sep;16(9):1067-74.

Download a copy

Please complete the STAS user and information registration form before downloading the STAS if you intend to use it. Please complete and send the form to:

Executive Administrator
Department of Palliative Care, Policy & Rehabilitation
King's College London
Cicely Saunders Institute
Bessemer Road
Denmark Hill
London SE5 9PJ
United Kingdom
Tel: + 44 (0) 207 848 5516
Fax: + 44 (0) 207 848 5517
Email: palliativecare@kcl.ac.uk

STAS-S - STAS symptoms

Dr Jurgen Abela has developed a version of STAS focused on symptom management. This version of STAS was used for the evaluation of a community palliative care service.
For further information please contact jurgena@maltanet.net.

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