4 research outputs found

    Is the psycho-emotional situation complex in home palliative care? A multicenter study

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    Los cuidados paliativos en el domicilio pueden precisar, por criterios de complejidad psicoemocional, la intervención de equipos especializados o avanzados. La hospitalización a domicilio se presta a pacientes con necesidad de atención paliativa en su domicilio cuya complejidad es variable. Objetivo: Describir la presencia de causas de complejidad psicoemocional en los pacientes paliativos ingresados en hospitalización a domicilio en España. Método: Estudio descriptivo transversal y multicéntrico empleando la herramienta IDC-Pal realizado en ocho hospitales diferentes de hospitalización a domicilio repartidos por la geografía española. Los criterios de inclusión han sido: pacientes con mayoría de edad ingresados en régimen de hospitalización a domicilio con necesidad de cuidados paliativos. Resultados: En una muestra de 266 pacientes de 8 hospitales, 151 (57 %) eran hombres y 115 mujeres (43 %). La edad media de la muestra fue de 71,48 años (DE = 13,28). El 85,7 % de los pacientes presentaban al menos un criterio de alta complejidad para cualquier causa. 115 pacientes (47 %) presentaban al menos un criterio de complejidad psicoemocional, siendo la angustia existencial o sufrimiento espiritual el más frecuente. Conclusiones: La situación psicoemocional compleja se presenta en aproximadamente la mitad de los pacientes ingresados en hospitalización a domicilio. El sufrimiento espiritual merece una atención particular en este grupo de pacientes.Palliative care at home might require, by criteria of psycho-emotional complexity, the intervention of specialized or advanced teams. Hospital-at-home is provided to patients who need palliative care at home and whose complexity is variable. Aim: To describe the causes of psycho-emotional complexity in palliative patients admitted to hospitalat- homes in Spain. Method: Cross-sectional and multicenter descriptive study using the IDCPal tool carried out in eight different hospitals of Hospital-at-home distributed throughout the Spanish geography. The inclusion criteria were: patients with legal age admitted to Spanish hospital-at-homes and who need palliative care. Results: In a sample of 266 patients from 8 hospitals, 151 (57 %) were men and 115 women (43 %). The mean age of the sample was 71.48 years (SD = 13.28), 85.7 % of the patients had at least one criterion of high complexity for any cause, 115 patients (47 %) had at least one criterion of psycho-emotional complexity, being the existential anguish or spiritual suffering the most frequent. Conclusions: The complex psycho-emotional situation occurs in approximately half of the patients admitted to hospital-at-homes. Spiritual suffering deserves special focus in this group of patients.Enfermerí

    The Confusion Assessment Method Could Be More Accurate than the Memorial Delirium Assessment Scale for Diagnosing Delirium in Older Cancer Patients: An Exploratory Study

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    Background: Older people with cancer carry a high risk of delirium, an underdiagnosed syndrome due to its diagnostic complexity and often subtle presentation. Tools based on the Diagnostic and Statistical Manual of Mental Disorders (DSM) are available to different health professionals. Our aim is to assess the prevalence of delirium in older people with cancer in an inpatient unit and the accuracy of the Confusion Assessment Method (CAM) and Memorial Delirium Assessment Scale (MDAS). Methods: This exploratory, cross-sectional study included people aged 65 years or older with a diagnosis of cancer and admitted to the medical oncology unit from June 2021 to December 2022. The diagnostic accuracy of CAM and MDAS was analyzed against the gold standard medical diagnosis based on DSM-5 criteria by two medical oncologists. The cutoff point for the MDAS was determined using a receiver-operating characteristics (ROC) curve. Results. Among the 75 included patients (mean age 71.6 years, standard deviation 4.1; 52% males), the prevalence of delirium was 62.7%. The most prevalent types of cancer in patients with delirium were hematological and lung cancer. The scale with the highest diagnostic accuracy was the CAM, with a sensitivity of 100% and specificity of 86%, followed by the MDAS, with a sensitivity of 88% and specificity of 30%. The presence of cognitive impairment hindered the detection of delirium. Conclusions. The CAM scale was more accurate than the MDAS pre-existing cognitive impairment in our sample. Further studies are needed to analyze the diagnostic accuracy of delirium tools in older populations with cancer and in the presence of cognitive impairment

    The Confusion Assessment Method Could Be More Accurate than the Memorial Delirium Assessment Scale for Diagnosing Delirium in Older Cancer Patients: An Exploratory Study

    No full text
    Background: Older people with cancer carry a high risk of delirium, an underdiagnosed syndrome due to its diagnostic complexity and often subtle presentation. Tools based on the Diagnostic and Statistical Manual of Mental Disorders (DSM) are available to different health professionals. Our aim is to assess the prevalence of delirium in older people with cancer in an inpatient unit and the accuracy of the Confusion Assessment Method (CAM) and Memorial Delirium Assessment Scale (MDAS). Methods: This exploratory, cross-sectional study included people aged 65 years or older with a diagnosis of cancer and admitted to the medical oncology unit from June 2021 to December 2022. The diagnostic accuracy of CAM and MDAS was analyzed against the gold standard medical diagnosis based on DSM-5 criteria by two medical oncologists. The cutoff point for the MDAS was determined using a receiver-operating characteristics (ROC) curve. Results. Among the 75 included patients (mean age 71.6 years, standard deviation 4.1; 52% males), the prevalence of delirium was 62.7%. The most prevalent types of cancer in patients with delirium were hematological and lung cancer. The scale with the highest diagnostic accuracy was the CAM, with a sensitivity of 100% and specificity of 86%, followed by the MDAS, with a sensitivity of 88% and specificity of 30%. The presence of cognitive impairment hindered the detection of delirium. Conclusions. The CAM scale was more accurate than the MDAS pre-existing cognitive impairment in our sample. Further studies are needed to analyze the diagnostic accuracy of delirium tools in older populations with cancer and in the presence of cognitive impairment

    ¿Es compleja la situación psicoemocional en los cuidados paliativos en el domicilio?: estudio multicéntrico

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    Palliative care at home might require, by criteria of psycho-emotional complexity, the intervention of specialized or advanced teams. Hospital-at-home is provided to patients who need palliative care at home and whose complexity is variable. Aim: To describe the causes of psycho-emotional complexity in palliative patients admitted to hospitalat-homes in Spain. Method: Cross-sectional and multicenter descriptive study using the IDCPal tool carried out in eight different hospitals of Hospital-at-home distributed throughout the Spanish geography. The inclusion criteria were: patients with legal age admitted to Spanish hospital-at-homes and who need palliative care. Results: In a sample of 266 patients from 8 hospitals, 151 (57 %) were men and 115 women (43 %). The mean age of the sample was 71.48 years (SD = 13.28), 85.7 % of the patients had at least one criterion of high complexity for any cause, 115 patients (47 %) had at least one criterion of psycho-emotional complexity, being the existential anguish or spiritual suffering the most frequent.Los cuidados paliativos en el domicilio pueden precisar, por criterios de complejidad psicoemocional, la intervención de equipos especializados o avanzados. La hospitalización a domicilio se presta a pacientes con necesidad de atención paliativa en su domicilio cuya complejidad es variable. Objetivo: Describir la presencia de causas de complejidad psicoemocional en los pacientes paliativos ingresados en hospitalización a domicilio en España. Método: Estudio descriptivo transversal y multicéntrico empleando la herramienta IDC-Pal realizado en ocho hospitales diferentes de hospitalización a domicilio repartidos por la geografía española. Los criterios de inclusión han sido: pacientes con mayoría de edad ingresados en régimen de hospitalización a domicilio con necesidad de cuidados paliativos. Resultados: En una muestra de 266 pacientes de 8 hospitales, 151 (57 %) eran hombres y 115 mujeres (43 %). La edad media de la muestra fue de 71,48 años (DE = 13,28). El 85,7 % de los pacientes presentaban al menos un criterio de alta complejidad para cualquier causa. 115 pacientes (47 %) presentaban al menos un criterio de complejidad psicoemocional, siendo la angustia existencial o sufrimiento espiritual el más frecuent
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