Cognition, functionality and symptoms in patients under home palliative care
Rev. Assoc. Med. Bras. (1992)
;
64(10): 922-927, Oct. 2018. graf
Article
in English
| LILACS
| ID: biblio-976788
ABSTRACT
SUMMARY OBJECTIVE: Evaluating the degree of cognition, functionality, presence of symptoms and medications prescribed for patients under palliative home care. METHOD: Descriptive, cross-sectional study where 55 patients under palliative home care were interviewed. Cognition was evaluated using the Mini-Mental state examination (MM), with patients being separated into two groups: with preserved cognitive ability (MM>24), or altered (MM <24). The functionality was verified by the Palliative Performance Scale (PPS) and the patients were divided into two groups: PPS≤50 and PPS≥60. The symptoms presence was evaluated by ESAS (Edmonton Symptom Assessment System) being considered as mild (ESAS 1-3), moderate (ESAS 4-6) or severe (ESAS 7-10) symptoms. Medications prescribed to control the symptoms were registered. Statistical analysis used Student's t test (p <0.05). RESULTS: Most of the 55 patients were women (63.6%), 70.9% of these had MM> 24, 83.6% had PPS <50 and 78.2% presented chronic non-neoplastic degenerative disease. There was a significant relationship between PPS≤50 and MM≤24. Symptoms were present in 98% of patients. Asthenia was more frequently reported and was not treated in 67% of the cases. Severe pain was present in 27.3%: 46% without medication and 13% with medication, if necessary. Most patients with severe dyspnea used oxygen. CONCLUSIONS: Most of the analysed patients had their cognition preserved, presented low functionality and 98% reported the presence of symptoms. Severe pain was present in almost 1/3 of the patients without effective treatment. Re-evaluate palliative home care is suggested to optimize patient's quality of life.
RESUMO
RESUMO OBJETIVO: Avaliar o grau de cognição, a funcionalidade, a presença de sintomas e as medicações prescritas para pacientes sob cuidados paliativos (CP) domiciliares. MÉTODO: Estudo transversal, descritivo, em que foram entrevistados 55 pacientes sob CP domiciliares. A cognição foi avaliada pelo miniexame do estado mental (MM), sendo os pacientes separados em dois grupos: com capacidade cognitiva preservada (MM>24) ou alterada (MM<24). A funcionalidade foi verificada pela performance paliativa (PPS), sendo os pacientes divididos em dois grupos: PPS<50 e PPS>60. A presença de sintomas foi analisada pelo ESAS, sendo considerados sintomas leves (ESAS 1-3), moderados (ESAS 4-6) ou graves (ESAS 7-10). Foram anotadas as medicações prescritas para o controle dos sintomas. Para análise estatística, foi utilizado teste t student's (p<0,05). RESULTADOS: Dos 55 pacientes entrevistados, a maioria era de mulheres (63,6%), 70,9% tinham MM>24, 83,6% tinham PPS<50 e 78,2% apresentavam doença crónica degenerativa não neoplásica. Houve relação significante entre PPS<50 e MM<24. Sintomas estavam presentes em 98% dos doentes. Astenia foi mais frequentemente apontada, não sendo tratada em 67% dos casos. Dor grave estava presente em 27,3%: 46% sem medicação e 13% com medicação se necessário. A maioria dos pacientes com dispneia grave usava oxigênio. CONCLUSÃO: A maioria dos pacientes tinha cognição preservada, apresentava baixa funcionalidade e referia a presença de sintomas. Dor grave estava presente em quase 1/3 dos pacientes, não lhes sendo prescrito tratamento eficaz. Sugere-se que sejam reavaliados os CP domiciliares com o objetivo da otimização da qualidade da vida dos pacientes.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Palliative Care
/
Cognition Disorders
/
Home Care Services
Type of study:
Diagnostic study
/
Observational study
/
Prevalence study
/
Risk factors
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
Language:
English
Journal:
Rev. Assoc. Med. Bras. (1992)
Year:
2018
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
PUCPR/BR
/
UFSC/BR
/
Unisul/BR
Similar
MEDLINE
...
LILACS
LIS