Tamizaje de aspectos psico-oncológicos: validación de una lista de chequeo

Objective: Develop and validate a Checklist of psycho-oncologic issues (LC-Psycho-onco) for oncologic patients in treatment. Method: We included 200 patients at the National Cancer Institute (INCAN). The sample collection was for availability during the period of October 2012 to January 2013. Results: An oblique factor analysis presented a three-factor model with 16 indicators and two reagents. The internal consistency of the global scale showed a satisfactory index (α= 0.811). The Cronbach’s alphas for each subscale were worth 0.753 and 0.507 which explain 43.81% of the variance. The validity through the correlation with concurrent measures showed significant results (Pearson’s r = .51 to .68, p<0.05). Conclusions: The LC-Psycho-onco showed adequate psychometric properties. Being a brief and easy instrument it is useful for both clinical practice and investigation. It provides a guide for planning psychological interventions.Objetivo: Desarrollar y validar una Lista de Chequeo de aspectos psico- oncológicos (LC-Psico-onco) en pacientes con cáncer en tratamiento médico. Método: Se entrevistó a 200 pacientes del Instituto Nacional de Cancerología de México (INCAN). La obtención de la muestra fue por disponibilidad en el periodo comprendido de Octubre de 2012 a Enero de 2013. Resultados: El análisis factorial oblicuo presentó un modelo de tres factores y 2 indicadores con 16 reactivos. La consistencia interna de la escala global mostró un índice satisfactorio (α=0,811). Las alfas de Cronbach de cada subescala tuvieron un valor de 0,753 y 0,507 que explican el 43,81% de la varianza. La validez por correlación con medidas concurrentes mostró resultados significativos (r de Pearson de 0,51 a 0,68, p<0,05). Conclusiones: La LC-Psico-onco presentó adecuadas características psicométricas. Al ser breve y fácil de aplicar tanto en la práctica clínica como en la investigación con población oncológica ofrece una guía en la planeación de evaluaciones exhaustivas y el diseño de un plan de tratamiento psicooncológic

Screening of psycho-oncologic issues: Validation of a checklist

Objective: Develop and validate a Checklist of psycho-oncologic issues (LC-Psycho-onco) for oncologic patients in treatment. Method: We included 200 patients at the National Cancer Institute (INCAN). The sample collection was for availability during the period of October 2012 to January 2013. Results: An oblique factor analysis presented a three-factor model with 16 indicators and two reagents. The internal consistency of the global scale showed a satisfactory index (α= 0.811). The Cronbach’s alphas for each subscale were worth 0.753 and 0.507 which explain 43.81% of the variance. The validity through the correlation with concurrent measures showed significant results (Pearson’s r = .51 to .68, p<0.05). Conclusions: The LC-Psycho-onco showed adequate psychometric properties. Being a brief and easy instrument it is useful for both clinical practice and investigation. It provides a guide for planning psychological interventions

Evolution over Time of Ventilatory Management and Outcome of Patients with Neurologic Disease∗

OBJECTIVES: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologic diseases. Hemorrhagic stroke and brain trauma were the most common pathologies associated with the need for mechanical ventilation. Although volume-cycled ventilation remained the preferred ventilation mode, there was a significant (p < 0.001) increment in the use of pressure support ventilation. The proportion of patients receiving a protective lung ventilation strategy was increased over time: 47% in 2004, 63% in 2010, and 65% in 2016 (p < 0.001), as well as the duration of protective ventilation strategies: 406 days per 1,000 mechanical ventilation days in 2004, 523 days per 1,000 mechanical ventilation days in 2010, and 585 days per 1,000 mechanical ventilation days in 2016 (p < 0.001). There were no differences in the length of stay in the ICU, mortality in the ICU, and mortality in hospital from 2004 to 2016. Independent risk factors for 28-day mortality were age greater than 75 years, Simplified Acute Physiology Score II greater than 50, the occurrence of organ dysfunction within first 48 hours after brain injury, and specific neurologic diseases such as hemorrhagic stroke, ischemic stroke, and brain trauma. CONCLUSIONS: More lung-protective ventilatory strategies have been implemented over years in neurologic patients with no effect on pulmonary complications or on survival. We found several prognostic factors on mortality such as advanced age, the severity of the disease, organ dysfunctions, and the etiology of neurologic disease