Comprehensive Assessment of Patients in Palliative Care

Mazzocato, Claudia; Stiefel, F.; Jonge, Peter de; Levorato, A.; Ducret, S.; Huyse, Frits J.

doi:10.1016/s0885-3924(99)00156-6

Cited by 35 publications

(19 citation statements)

References 20 publications

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“…The validity of this instrument has been documented in patients admitted to internal medicine [9], and also in specific diagnostic groups including patients in dialysis [17], with low back pain [18], terminal cancer [19], diabetes [2], rheumatoid arthritis [20], multiple sclerosis [11] and pulmonary patients [21]. It has also been shown that compared with usual care, nurse-led interventions based on INTERMED scores resulted in improvements in quality of life at discharge in a sample of general medical patients [22].…”

Section: Introductionmentioning

confidence: 99%

Reliability of INTERMED Spanish version and applicability in liver transplant patients: a cross-sectional study

Lobo

Rabanaque

Bellido³

et al. 2011

BMC Health Serv Res

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BackgroundIntegrated delivery methods in healthcare systems have been proposed to confront the increasing complexity in general health care. INTERMED is an empirically derived, observer-rated instrument to measure case complexity. It was intended as a visualized, action-oriented decision-support tool for the early assessment of bio-psychosocial health risks and health needs. This study aims to document the reliability and applicability of the Spanish version of INTERMED in liver transplant patients.MethodsCross-sectional study of patients who had been included in the liver transplant waiting list. Two nurses interviewed the patients with INTERMED, and scored the instrument blind to each other. Kappa and w-kappa, Spearman, Kendall and intraclass correlation coefficients, and Cronbach's alfa were calculated.ResultsNo patient refused the interview. Satisfactory coefficients were documented in most INTERMED items. Kappa was = 0.858 for the categorization of patients as "complex", and 21 of them (48.8%) were classified in this category, and were considered to need integrated treatment.ConclusionsThe Spanish version of INTERMED is reliable. Its applicability in liver transplant patients adds to its generalizability.

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Section: Introductionmentioning

confidence: 99%

Reliability of INTERMED Spanish version and applicability in liver transplant patients: a cross-sectional study

Lobo

Rabanaque

Bellido³

et al. 2011

BMC Health Serv Res

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“…In the process of its development, attention has been directed to the reliability, 6 validity, 12 and the clinical utility [13][14][15][16][17] of the INTERMED. Reliability has been studied in terms of inter-rater agreement, as another important goal of the INTERMED was to improve communication between health care professionals.…”

mentioning

confidence: 99%

The INTERMED: a screening instrument to identify multiple sclerosis patients in need of multidisciplinary treatment

Hoogervorst

Jonge

Jelles³

et al. 2003

Journal of Neurology, Neurosurgery &Amp; Psychiatry

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Objective: To analyse the value of the INTERMED, a screening instrument to assess case complexity, compared with the Expanded Disability Status Scale (EDSS) and the Guy's Neurological Disability Scale (GNDS) to identify multiple sclerosis (MS) patients in need of multidisciplinary treatment. Methods: One hundred MS patients underwent INTERMED, EDSS, and GNDS examinations. Patient care needs were assessed by a multidisciplinary team and a goal oriented treatment plan was defined. Correlations between INTERMED, individual INTERMED domains, EDSS, GNDS sum score, and total number of proposed disciplines involved in the treatment plan were studied. Results: Mean (SD) age was 40.6 (10.1) years. Median scores were 14.0 for the INTERMED, 4.0 for the EDSS, and 13.5 for the GNDS sum score. Moderate correlations were found between the INTERMED sum score and EDSS (r=0.59) and GNDS sum score (r=0.60). The number of disciplines as proposed by the multidisciplinary team showed the highest statistically significant correlation with the INTERMED sum score (r=0.41) compared with EDSS (r=0.32) and GNDS sum score (r=0.34). No significant or only weak correlations were found between the psychological domain of the INTERMED and EDSS or GNDS. Conclusion: The findings in this study show that there is an additional value of the INTERMED compared with the EDSS and GNDS in identifying MS patients in need of multidisciplinary treatment. The INTERMED domains show the area of the patient's vulnerability and care needs: especially the INTERMED's psychological and social domains may guide the clinician to deal with specific problems that complicate healthcare delivery.

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“…32,33 From an extensive list of potential risk factors for complexity mentioned in the literature, we developed a risk score, linearly related to all complexity indicators across the national samples. Using this risk score together with a method of integrating diagnostic information, [43][44][45][46][47][48][49][50][51] we present an alternative way of screening for patients requiring complex care in the general hospital. 31 The main advantages of this approach are that health care becomes preventive and can be planned at admission, as opposed to reacting to patient complications in the course of hospitalization.…”

Section: Discussionmentioning

confidence: 99%

Care Complexity in the General Hospital Results From a European Study

et al. 2001

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There is increasing pressure to effectively treat patients with complex care needs from the moment of admission to the general hospital. In this study, the authors developed a measurement strategy for hospital-based care complexity. The authors' four-factor model describes the interrelations between complexity indicators, highlighting differences between length of stay (LOS), objective complexity (such as medications or consultations), complexity ratings by the nurse, and complexity ratings by the doctor. Their findings illustrate limitations in the use of LOS as

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Comprehensive Assessment of Patients in Palliative Care

Cited by 35 publications

References 20 publications

Reliability of INTERMED Spanish version and applicability in liver transplant patients: a cross-sectional study

Reliability of INTERMED Spanish version and applicability in liver transplant patients: a cross-sectional study

The INTERMED: a screening instrument to identify multiple sclerosis patients in need of multidisciplinary treatment

Care Complexity in the General Hospital Results From a European Study

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