The Spanish Adaptation of the Palliative Performance Scale (Version 2) Among Cancer Patients at the End of Life: Psychometric Properties.

BACKGROUND: Palliative Performance Scale (PPS) is a reliable tool to assess performance status in cancer patients receiving palliative care (PC). Spanish validated and culturally adapted tools are needed. OBJECTIVES: The objectives are to develop PPS translation and cross-cultural adaptation into Spanish and to assess its psychometric properties. DESIGN: Translation process with cross-cultural adaptation to produce Spanish Palliative Performance Scale (PPS-SPANISH). SETTINGS: PC Team at one University hospital in Spain. PARTICIPANTS: Fifteen advanced cancer patients (60 assessments) were included for PPS translation and validation and 250 patients for cross-sectional analysis. All participants were recruited at oncology ward, emergency area, and outpatient clinic by PC team professionals. Informed consent was given. Average age was 66.4 ± 13 years (60% men). METHODS: The process is designed in three steps. In Step 1, PPS translation and reverse translation into Spanish (three bilingual speakers) and linguistic complexity measurement were performed. In Step 2, readability and intelligibility assessment was carried out. In Step 3, a pilot study was conducted to assess test-retest reliability followed by a cross-sectional study to measure internal consistency. Inclusion criteria were the same for two samples. Demographic data were also analyzed by descriptive statistics. RESULTS: Following cultural, linguistic, and grammatical adaptation, PPS-SPANISH was readable and reliable. The analysis of the test-retest reliability after 48 hours showed intraclass correlations >0.60. Cronbach's alpha coefficient was 0.99 (0.988-0.992). There was high agreement with other functional assessment tools (Barthel Index and Karnofsky Performance Status Index). CONCLUSIONS: PPS-SPANISH showed reliability and validity, and it is suitable to assess performance status in cancer patients receiving PC.

Prevalencia y severidad de la disfunción intestinal inducida por opioides / Observational and cross-sectional study of prevalence and severity of the opioid-induced bowel dysfunction

OBJETIVO: Analizar la prevalencia y severidad de los síntomas de disfunción intestinal inducida por opioides (DIO). DISEÑO: Estudio epidemiológico, observacional y transversal. Emplazamiento: Seis hospitales españoles. Participantes: Trescientos diecisiete pacientes en régimen ambulatorio con diagnóstico de dolor oncológico o dolor crónico no oncológico tratados con un único opioide mayor. Mediciones principales: La prevalencia de los síntomas de DIO y su severidad se midió usando una escala visual analógica (EVA: 0-100) y el estreñimiento se valoró también mediante el índice de función intestinal (BFI). Se registró el tratamiento para los síntomas gastrointestinales y se comparó su frecuencia según el tratamiento opioide. Finalmente, se estudió la calidad de vida. RESULTADOS: La tasa de prevalencia de al menos un trastorno gastrointestinal potencialmente relacionado con la DIO fue del 94,6%, siendo el estreñimiento el síntoma más frecuente (BFI: 91,6%; EVA: 90,2%) y casi la mitad de los pacientes (49,8%) presentaron 3 o más síntomas con un EVA ≥ 4. No se detectaron diferencias significativas en la prevalencia de los síntomas entre los distintos tratamientos opioides. Se detectó una afectación en la calidad de vida de los pacientes relacionada con la presencia de síntomas gastrointestinales de moderada a severa. CONCLUSIONES: En pacientes con tratamiento opioide se constata una elevada frecuencia de trastornos gastrointestinales posiblemente relacionados con la DIO, lo que subraya la necesidad de nuevas estrategias para su tratamiento (AU)

OBJECTIVE: To analyze the prevalence and severity of the opioid-induced bowel dysfunction(OBD) symptoms. DESIGN: Epidemiological, observational and cross-sectional study. Location: Six Spanish centers participated. Participants: A total of 317 outpatients with a diagnosis of cancer pain or non-cancer pain treated with a unique opioid were recruited. Main measurements: The prevalence of OBD symptoms was measured using a visual analog scale (VAS: 0-100), and constipation was also assessed by the Bowel Function Index (BFI). The treatment for gastrointestinal symptoms was recorded, and the frequency of symptoms between different opioid treatments was compared. Finally, quality of life was evaluated. RESULTS: The prevalence of OBD with at least one gastrointestinal disorder was 94.6%, with constipation being the most frequent symptom (BFI: 91.6%; VAS: 90.2%) and nearly half of the patients showed three or more symptoms with a VAS≥4. No significant differences were detected in the prevalence of symptoms between the opioid groups. A decrease in the wellbeing of patients was detected related to moderate to severe gastrointestinal symptoms. CONCLUSIONS: A high rate of gastrointestinal disorders probably related to OBD have been confirmed in patients on opioid therapy, highlighting the need for new drug strategies (AU)

[Observational and cross-sectional study of prevalence and severity of the opioid-induced bowel dysfunction]. / Prevalencia y severidad de la disfunción intestinal inducida por opioides.

OBJECTIVE: To analyze the prevalence and severity of the opioid-induced bowel dysfunction (OBD) symptoms. DESIGN: Epidemiological, observational and cross-sectional study. LOCATION: Six Spanish centers participated. PARTICIPANTS: A total of 317 outpatients with a diagnosis of cancer pain or non-cancer pain treated with a unique opioid were recruited. MAIN MEASUREMENTS: The prevalence of OBD symptoms was measured using a visual analog scale (VAS: 0-100), and constipation was also assessed by the Bowel Function Index (BFI). The treatment for gastrointestinal symptoms was recorded, and the frequency of symptoms between different opioid treatments was compared. Finally, quality of life was evaluated. RESULTS: The prevalence of OBD with at least one gastrointestinal disorder was 94.6%, with constipation being the most frequent symptom (BFI: 91.6%; VAS: 90.2%) and nearly half of the patients showed three or more symptoms with a VAS ≥ 4. No significant differences were detected in the prevalence of symptoms between the opioid groups. A decrease in the wellbeing of patients was detected related to moderate to severe gastrointestinal symptoms. CONCLUSIONS: A high rate of gastrointestinal disorders probably related to OBD have been confirmed in patients on opioid therapy, highlighting the need for new drug strategies.