Use of complementary and alternative medicine by cancer patients in Colombia.

BACKGROUND: The use of complementary and alternative medicines (CAM) among cancer patients varies greatly. The available data suggest an increasing use of CAM over time and a higher prevalence in low- and middle-income countries. However, no reliable data are available from Latin America. Accordingly, we examined the prevalence of CAM use among cancer patients from six Colombian regions. METHODS: We conducted a survey on cancer patients attending comprehensive cancer centres in six capital cities from different regions. The survey was designed based on a literature review and information gathered through focus groups on CAM terminology in Colombia. Independent random samples of patients from two comprehensive cancer centres in every city were obtained. Patients 18 years and older with a histopathological diagnosis of cancer undergoing active treatment were eligible. The prevalence of CAM use is reported as a percentage with the corresponding confidence interval. CAM types are reported by region. The sociodemographic and clinical characteristics of CAM users and non-users were compared using Chi square and t tests. RESULTS: In total, 3117 patients were recruited. The average age 59.6 years old, and 62.8% were female. The prevalence of CAM use was 51.7%, and compared to non-users, CAM users were younger, more frequently women, affiliated with the health insurance plan for low-income populations and non-Catholic. We found no differences regarding the clinical stage or treatment modality, but CAM users reported more treatment-related side effects. The most frequent types of CAM were herbal products, specific foods and vitamins, and individually, soursop was the most frequently used product. Relevant variability between regions was observed regarding the prevalence and type of CAM used (range: 36.6% to 66.7%). The most frequent reason for using CAM was symptom management (30.5%), followed by curative purposes (19.5%). CONCLUSIONS: The prevalence of CAM use among cancer patients in Colombia is high in general, and variations between regions might be related to differences in cultural backgrounds and access to comprehensive cancer care. The most frequently used CAM products and practices have little scientific support, suggesting the need to enhance integrative oncology research in the country.

Validación de la escala QLQ-C15 PAL, para evaluar calidad de vida en pacientes en cuidados paliativos, al español colombiano / Validation of the QLQ-C15 PAL Scale, to assess quality of life in patients in palliative care, to colombian spanish

Validar la escala QLQ C15 PAL, para evaluar calidad de vida en pacientes en cuidados paliativos, al español colombiano, considerando un análisis psicométrico desde la teoría clásica de los test. Método: Muestra por conveniencia de 155 pacientes oncológicos atendidos por el Programa de Cuidados Paliativos de un grupo de centros hospitalarios en las ciudades de Bogotá y Cali en Colombia. Para estimar la validez de constructo, se utilizó el análisis factorial exploratorio (AFE) con rotación varimax; posteriormente, se usaron cargas factoriales para estimar el coeficiente Omega y posteriormente el análisis de Rash reconocido Análisis de la Teoría de la respuesta al ítem (TRI). El análisis fue realizado en Winsteps 2.80. Resultados: Todas las correlaciones son significativas entre los ítems de la escala Funcionamiento Global (FG) con el puntaje total obtenido en esta escala y el puntaje total del QLQ PAL-15; la misma situación ocurre con los ítems de la escala Funcionamiento Emocional (FE) que correlaciona de modo directamente proporcional y con una magnitud alta con el puntaje total del QLQ PAL-15. En cuanto al total de la escala, existe un adecuado ajuste para los ítems ya que sus valores Infit: (IMNSQ 0,99; ZSDT: -0,3) y Outfit (OMNSQ 1,02; ZSDT-0,2) se encuentran dentro de los rangos establecidos como parámetros de ajuste. Conclusiones: La validación del EORTC QLQ-C15-PAL demostró propiedades psicométricas satisfactorias al aplicarse en pacientes con enfermedad oncológica avanzada en Colombia. Se plantea para estudios posteriores realizar ajuste en la redacción de los ítems 7,11 y 13 para que estos discriminen de manera precisa el rasgo que pretenden medir (AU)

Validate the QLQ C15 PAL scale, to assess the quality of life in patients in palliative care, to Colombian Spanish, based in a classical psychometric analysis. Methodology: Convenience sample of 155 cancer patients attended by the Palliative Care Program of a group of hospitals in the cities of Bogota and Cali in Colombia. To estimate construct validity, exploratory factor analysis (AFE) with varimax rotation was used; Factorial loads were subsequently used to estimate the Omega coefficient and subsequently Rash’s recognized Analysis of Item Response Theory (TRI). The analysis was performed on Win steps 2.80. Results: All correlations are significant between the items on the Global Operation (FG) scale with the total score obtained on this scale and the total score of the QLQ PAL-15; the same situation occurs with items on the Emotional Functioning (FE) scale that correlates directly proportionally and with a high magnitude with the total score of QLQ PAL-15.As for the total scale, there is an appropriate adjustment for the items since their Infit values: (IMNSQ 0.99, ZSDT: -0.3) and Outfit (OMNSQ 1.02, ZSDT-0.2) are within the ranges set as adjustment parameters. Conclusion:The validation of the EORTC QLQ-C15-PAL demonstrated satisfactory psychometric properties in patients with advanced cancer disease in Colombia. It is proposed for subsequent studies to adjust the wording of items 7,11 and 13 so that they discriminate in a precise way the feature that they intend to measure (AU)

Dolor en pacientes hospitalizados en una institución de salud de tercer nivel / Pain in hospitalized patients in a third-level health care institution

Abstract Introduction: Pain is one of the major symptoms experienced by hospitalized patients. Objective: To establish the hospital care quality indicators associated with pain management (prevalence, intensity, and interference) in adult inpatients, following the implementation of strategies framed within the pain-free Hospital Policy at a third-level institution. Methodology: Observational, descriptive, cross-sectional trial. Patients over 18 years of age, hospitalized for more than 24hours, and who previously signed their informed consent were included. The Brief Pain Inventory - Short Form in Spanish was adminis tered for pain evaluation, and the sex and service differences were estimated using the Wilcoxon test for quantitative variables and x2 for qualitative variables. Results: Three hundred thirty-eight participants were includ ed. The prevalence of pain was 43.4%, with a higher percentage among females (52.1% vs 28.8%, P <0.001) and in the surgical services (48.0% vs 37.5%, P = 0.05). Women showed higher intensity in the "minimum pain" item (median 3 interquartile range 2-5 vs median 2 interquartile range 0-1, P=0.009). The activities with the highest interference were sleep and general activity in both sexes and services. Discussion: The hospital quality of care indicators herein measured allow for an enhanced approach to characterize pain in this population group, with a view to improving pain identifica tion and management in the future to provide a more comfortable experience for the patient.

Resumen Introducción: El dolor es uno de los principales síntomas que presentan los pacientes hospitalizados. Objetivo: Establecer los indicadores de la calidad del cuidado hospitalario relacionados con el manejo del dolor (prevalencia, intensidad e interferencia) en pacientes adultos hospitalizados posterior a la implementación de estrategias enmarcadas en la Política Clínica sin dolor de una institución de tercer nivel. Metodología: Estudio observacional descriptivo de corte transversal. Se incluyeron pacientes mayores de 18 años con más de 24 horas de hospitalización y previa firma de consenti miento informado, se aplicó el instrumento Brief Pain Inventory -Short Form (Inventario Breve de Dolor) en español para la evaluación del dolor. Las diferencias por género y servicio se estimaron a través del test de Wilcoxon para las variables cuantitativas y X2 para las variables cualitativas. Resultados: Se incluyeron 338 participantes. La prevalencia de dolor fue 43,4%, siendo más alta en mujeres (52,1% vs. 28,8%, p = < 0.001) y servicios quirúrgicos (48,0% vs. 37,5%, p = 0.05). Las mujeres presentaron mayor intensidad en el ítem "dolor mínimo" (mediana 3 Rango intercuartílico 2-5 vs. mediana 2 Rango intercuartílico 0-1, p = 0.009). Las actividades con mayor interferencia fueron el sueño y la actividad general en ambos sexos y servicios. Discusión: Los indicadores de la calidad del cuidado hospita lario medidos en este estudio permiten caracterizar de una mejor forma el dolor en este tipo de población, lo cual permite mejorar a futuro la identificación y manejo de éste síntoma para brindar mayor confort al paciente.