4 research outputs found
Is the psycho-emotional situation complex in home palliative care? A multicenter study
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
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
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
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