Cuidados al fin de la vida en geriatría / Care at the end of life in geriatrics

With aging, there are various geriatric syndromes that along with the most prevalent chronic diseases make harder the clinical management of the senior citizen patient. It is known that cancer as a disease is included in many palliative programs in the world, not so, another kind of chronic and degenerative diseases that gradually advance to cause the death of many patients. The intention of this document is to review the recommendations in order to give a better care at the end of the life of the geriatric patient. Always taking into account that people have the right to receive an adequate medical care with quality and that nowadays it is not possible that a sick person presents suffering by their uncontrolled symptoms. It is a work of the society and professionals to improve knowledge of palliative medicine and have a humane and compassionate attitude towards the terminal patient.

Development and Validation of the Hospice Palliative Care Performance Scale

PURPOSE: The purpose of this study was to develop and validate a hospice / palliative care performance measure which would cover more than just physical symptoms or quality of life. METHODS: Through an intensive literature review, the author chose questions that measured aspects of physical, emotional, spiritual, social, or practical domains pertinent to hospice / palliative care for inclusion in the scale. Content validation of the questions was established by 15 hospice / palliative care professionals. A preliminary Hospice Palliative Care Performance Scale (HPCPS) of 20 questions was administered to 134 pairs of terminal cancer patients from 5 hospice palliative care units and their main family caregiver. A validation study was conducted to evaluate construct validity and internal consistency. RESULTS: Factor analysis showed 14 significant questions in five subscales; Physical, Emotional, Spiritual, Social, and Patient' rights. There were no significant differences between the ratings by patients and family members except for three out of the 14 questions. The measure demonstrated construct validity, and Cronbach's alpha of the subscales ranged from .73 to .79. CONCLUSION: The HPCOS demonstrated acceptable validity and reliability. It can be used to assess effectiveness of hospice / palliative care for terminal cancer patients in practice and research.

Avaliação do instrumento Edmonton Symptom Assessment System em cuidados paliativos: revisão integrativa / Evaluación de la herramienta Edmonton Symptom Assessment System en cuidados paliativos: una revisión integrador / Assessment of the instrument Edmonton Symptom Assessment System in hospice care: an integrative review

Cuidados Paliativos (CP) são prestados a pacientes fora de possibilidades terapêuticas de cura, tendo como foco o controle dos sintomas e melhora da qualidade de vida. A Edmonton Symptom Assessment System (ESAS) é um instrumento para avaliar e monitorar nove sintomas físicos e psicológicos em pacientes de CP. O estudo objetiva realizar revisão integrativa acerca da avaliação dos profissionais de saúde e/ou pacientes quanto ao uso da ESAS em pacientes oncológicos em Cuidados Paliativos. Foram localizados oito artigos no Medical Literature Analysis and Retrieval System Online (MEDLINE) entre 1998 e 2009. Os resultados mostraram que apesar de haver poucos estudos sobre este assunto, a ESAS é um instrumento válido para detectar e monitorar sintomas nos CP, apresentando algumas limitações. Os resultados apontam para a importância da continuidade do estudo de tradução e adaptação transcultural desta escala para o português do Brasil.

A los pacientes fuera de posibilidades terapéuticas de cura, se brindan cuidados paliativos teniendo como objetivo el control de los síntomas y la mejora de la calidad de vida. La Edmonton Symptom Assessment System (ESAS) es una herramienta para evaluar y monitorear nueve síntomas físicos y psicológicos en pacientes de CP. Este estudio objetiva realizar una revisión integradora acerca de la evaluación de los profesionales de salud y/o pacientes en cuanto al uso de ESAS en pacientes con cáncer en cuidados paliativos. Se encontraron ocho artículos en Medical Literature Analysis and Retrieval System Online (MEDLINE) entre 1998 y 2009. Los resultados revelaron que aunque hay pocos estudios sobre el tema, la ESAS es una herramienta válida para detectar síntomas en los CP, aunque presente algunos límites. Los resultados señalan la importancia de la continuidad del estudio de traducción y adaptación transcultural de esa escala al portugués de Brasil.

Hospice Care (HC) is given to patients out of therapeutic possibilities of cure, focusing on symptoms control and life quality. The Edmonton Symptom Assessment System (ESAS) is an instrument to assess and monitor nine physical and psychological symptoms in patients in HC. The study aims to perform an integrative review on the assessment of health professionals and/or patients regarding the use of ESAS in cancer patients in Hospice Care. Eight papers have been localized at Medical Literature Analysis and Retrieval System Online (MEDLINE) between 1998 and 2009. The results displayed that although there are few studies on this topic, the ESAS is a valid instrument to detect and monitor symptoms in HC, presenting some limitations. The results led to the importance of the study continuity in translation and cross-cultural adaptation of this scale to Brazilian Portuguese.