[Prevalence and typology of patients susceptible of palliative care deceased at home]. / Prevalencia y tipología de pacientes susceptibles de cuidados paliativos fallecidos en el domicilio.

BACKGROUND: Identification of patients susceptible to palliative care (SPC) in the community is essential for improving their clinical management. The objective is to explore the SPC population and their typology of illness, according to sex. METHODS: Cross-sectional study, performed on the population of Malaga who died at home during 2015. Association between type of patient (SCP or identified as palliative by inclusion in the integrated care process (ICP)). Age, sex and type of disease were analyzed with Chi square and t-Student's test. RESULTS: Of 950 patients attended to after dying at home, 417 (43.9%) were SCP and, of them, 277 (66,4%) were included in the ICP. Males were more frequent in both populations (55.6 and 59.9%, respectively, p=0,26), with mean ages 78.6 and 76.2, respectively (p=0.01). The most frequent diseases in SCP patients were: cancer (61.9%), dementia and Alzheimer (19.9%), chronic ob-structive pulmonary disease (COPD) (6.2%) and heart failure (4.1%). People with cancer were more frequently included in the ICP (86.8%), while those with dementia and Alzheimer, COPD and Parkinson were less frequently included (20.5, 38.4 and 0.4% respectively). By sex, men suffered more from cancer and women from dementia. Percentage of inclusion in ICP was similar for men and women, stratified by disease. CONCLUSIONS: Almost half of the people who died at home are SCP although only two out of three are identified as such. Cancer is the most frequent SCP disease and the easiest one to identify, largely affecting men. Three out of four people with dementia died without being identified as PC, and they are mainly women.

[Validity and reliability of the personalised nursing care index in a hospital medical unit]. / Validez y fiabilidad del índice de personalización de cuidados en una unidad médica hospitalaria.

OBJECTIVES: To determine the validity and reliability of the personalised nursing care index (PNCI). METHODS: A descriptive study was carried out in the Puerta del Mar Hospital (Cádiz) of the Andalusian Health Service, which included all patients admitted to an Internal Medicine ward from May 2007 to July 2008. A descriptive analysis was performed on the population included in the study. Furthermore, reliability was analysed with the 20-Kuder-Richardson coefficient and a correlation matrix between PNCI items; and validity via a maximum likelihood factorial analysis, and a ROC curve to determine sensitivity and specificity. RESULTS: A total of 219 people were included in the survey, of whom 74.4% were patients and 26.6% caregivers. The percentages of males and females were similar with a mean age of 62.5 years and 48.4% finished basic school education. The 20-Kuder-Richarson value was 0.835; and a positive correlation between items, which corresponded to 3 groups of items (factors). The maximum likelihood factorial analysis confirmed the 3 items-factor groups with a Promax rotation due to the high correlation between them. The maximum explained variance was 91.42%. The ROC curve area was 90.1% with a cut-off point of 8, for a sensitivity of 79.9% and a specificity of 90.6%. CONCLUSIONS: The PCNI is reliable, with the internal consistency coefficient value in between an optimum range. Furthermore, factors obtained from the matrix correlation inter-items were confirmed with a factorial analysis, resulting in a high explained variance. The curve ROC area is excellent compared to the gold standard, considered as the perception of confidence relationship.