Palliative Care Needs in an Acute Internal Medicine Ward in Mexico

Zertuche-Maldonado, Tania; Tellez-Villarreal, Rodrigo; Pascual, Antonio; Valdovinos-Chávez, Salvador Bruno; Barragán-Berlanga, Abel Jesús; Sánchez-Ávila, María Teresa; Bracho-Vela, Leonardo; Tinoco-Aranda, Adria; Bruera, Éduardo

doi:10.1089/jpm.2017.0043

Cited by 10 publications

(11 citation statements)

References 23 publications

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“…Proportions of patients with PC needs vary (9-73%), and people are often identified late in their disease trajectory, which bears important consequences for care [9][10][11][12][13][14][15][16][17][18]. These consequences include, but are not limited to (i) excess hospital mortality, whereby 80% of palliative patients die in hospital when the majority of people wish to die at home [19,20]; (ii) suboptimal symptom management [21][22][23]; (iii) unplanned hospitalisations with long hospital stays [24,25]; (iv) prescription of inappropriate treatments due to a lack of advance care planning [26,27]; and, (v) insufficient support for the patient and their relatives [24,28,29].…”

Section: Introductionmentioning

confidence: 99%

IDentification of patients in need of general and specialised PALLiative care (ID-PALL©): item generation, content and face validity of a new interprofessional screening instrument

et al. 2020

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Background: Early identification of patients requiring palliative care is a major public health concern. A growing number of instruments exist to help professionals to identify these patients, however, thus far, none have been thoroughly assessed for criterion validity. In addition, no currently available instruments differentiate between patients in need of general vs. specialised palliative care, and most are primarily intended for use by physicians. This study aims to develop and rigorously validate a new interprofessional instrument allowing identification of patients in need of general vs specialised palliative care. Methods: The instrument development involved four steps: i) literature review to determine the concept to measure; ii) generation of a set of items; iii) review of the initial set of items by experts to establish the content validity; iv) administration of the items to a sample of the target population to establish face validity. We conducted a Delphi process with experts in palliative care to accomplish step 3 and sent a questionnaire to nurses and physicians non-specialised in palliative care to complete step 4. The study was conducted in the French and Italian-speaking regions of Switzerland. An interdisciplinary committee of clinical experts supervised all steps. Results: The literature review confirmed the necessity of distinguishing between general and specialised palliative care needs and of adapting clinical recommendations to these different needs. Thirty-six nurses and physicians participated in the Delphi process and 28 were involved in the face validity assessment. The Delphi process resulted in two lists: a 7-item list to identify patients in need of general PC and an 8-item list to identify specialised PC needs. The content and face validity were deemed to be acceptable by both the expert and target populations.

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Section: Introductionmentioning

confidence: 99%

IDentification of patients in need of general and specialised PALLiative care (ID-PALL©): item generation, content and face validity of a new interprofessional screening instrument

et al. 2020

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“…Prevalence of patients in need of PC varies from 9% to 73% in various acute care settings, with the highest prevalence occurring in clinical settings, such as internal medicine or oncology (5)(6)(7)(8)(9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

IDentification of patients in need of general and specialised PALLiative care (ID-PALL©): item generation and content validity of a new interprofessional screening instrument.

Lüthi¹,

Bernard²,

Beauverd³

et al. 2019

Preprint

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Background Early identification of patients requiring palliative care is a major public health concern. A growing number of instruments exist to help professionals in identifying these patients, but thus far, none have been thoroughly assessed for criterion validity. In addition, no currently available instruments differentiate between patients in need of general vs. specialized palliative care, and most are primarily intended for physicians’ use. This study aims to develop a new interprofessional instrument allowing identification of patients in need of general vs specialized palliative care.Methods The instrument development consisted of four steps: i) literature review to determine the concept to measure; ii) generation of a set of items; iii) review of the initial set of items by experts to establish the content validity; iv) administration of the items to a sample of the target population to establish face validity. We conducted a Delphi process with experts in palliative care to accomplish step 3 and sent a questionnaire to nurses and physicians non-specialised in palliative care to achieve step 4. A committee of interdisciplinary clinical experts supervised all steps.Results The study was conducted in the French - and Italian-speaking regions of Switzerland. The literature review confirmed the necessity of distinguishing between general and specialised palliative care needs and of adapting clinical recommendations to these different needs. Thirty-six nurses and physicians participated in the Delphi process and 28 were involved in the face validity assessment. The Delphi process resulted in two item lists: a 7-items list to identify patients in need of general PC and an 8-items list for specialised PC needs. The content and face validity were deemed to be acceptable by both the expert and the target populations.Conclusion This instrument considers a new perspective in the identification of patients requiring palliative care as it has been designed to differentiate between general and specialised palliative care needs. Moreover, diagnostic data is not fundamental to the use of the instrument, thus facilitating its use by healthcare professionals other than physicians, in particular nurses. Internal and criterion validity assessments are ongoing and essential before further dissemination of the instrument.

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“…Prevalence varies from 9% to 73% in acute care settings depending on pathologies, co-morbidities or frailty. [1][2][3][4][5] An international prevalence study revealed that the proportion of individuals who died from diseases indicating a need for palliative care ranged from 38% to 74%. 6 According to Murtagh et al, 7 63% to 82% of the population will need palliative care at some point of their disease trajectory.…”

Section: Introductionmentioning

confidence: 99%

Instruments for the identification of patients in need of palliative care

Lüthi

Mabire

Amoussou

et al. 2019

JBI Database of Systematic Reviews and Implementation Reports

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Instruments for the identification of patients in need of palliative care: a systematic review protocol of measurement properties Abstract Objective: to provide a comprehensive overview of the psychometric properties of available clinicianreported instruments developed to identify patients in need of general and specialized palliative care in acute care settings.Introduction: Identification of patients in need of palliative care has been recognized as an area where many healthcare professionals need guidance. Differentiating between patients who require general palliative care and patients with more complex conditions who need specialized palliative care is particularly challenging. To our knowledge, no instrument are available to date to assist healthcare professionals to make this identification.Inclusion criteria: Will be included studies reporting : i) instruments aiming to identify patients in need of PC, ii) sample of adult patients in need of PC in acute care settings, iii) Clinician-reported outcome measures (ClinROMs), iv) the development process or one or more of its measurement properties. Will be excluded studies conducted intensive care units, emergency departments, and nursing homes. Methods:We will search studies published in English and French in: Embase.com, Medline Ovid SP, Pubmed, and CINAHL EBSCO and other sources, such as Google Scholar, government websites, and hospice websites. All citations will be screened and selected by two independent reviewers. Data extraction, quality assessment, and syntheses of included studies will be performed according to the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) criteria.PROSPERO systematic review registration number: CDR42020150074.

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Palliative Care Needs in an Acute Internal Medicine Ward in Mexico

Abstract: The number of patients requiring palliative care in internal medicine wards may be excessive to the current palliative care structures available.

Cited by 10 publications

References 23 publications

IDentification of patients in need of general and specialised PALLiative care (ID-PALL©): item generation, content and face validity of a new interprofessional screening instrument

IDentification of patients in need of general and specialised PALLiative care (ID-PALL©): item generation, content and face validity of a new interprofessional screening instrument

IDentification of patients in need of general and specialised PALLiative care (ID-PALL©): item generation and content validity of a new interprofessional screening instrument.

Instruments for the identification of patients in need of palliative care

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