Department of Nursing, University of Granada, 18016 Granada, Spain.
Doctoral Programme in Clinical Medicine and Public Health, University of Granada, 18012 Granada, Spain.
Int J Environ Res Public Health. 2021 Mar 19;18(6):3171. doi: 10.3390/ijerph18063171.
Proper planning of Palliative Care in nursing homes requires advanced knowledge of the care needs that residents show. The aim of the study was to evaluate Palliative Needs and other conditions such as fragility, complexity, and prognosis and also to suggest new indicators for the establishment of the resident's advanced chronic condition.
Cross-sectional study conducted in 149 nursing homes Complex Chronic residents evaluated by trained professionals. Palliative Care Needs, assessed by the NECPAL ICO-CCOMS© tool, and fragility, case and palliative complexity and prognosis were evaluate through a comprehensive assessment. Descriptive analyses and association measures were performed setting the statistical significance at 0.05.
More than 50% of the residents had positive Surprise Question and other Palliative Needs and were classified as Advanced Chronic Patients. Distress and/or Severe Adaptative Disorder was the most frequent need shown by the residents and significant differences in levels of frailty and other characteristics, were found between the Positive and the Negative Surprise Question Groups. Statistically significant correlations were also found between aspects of both groups.
Nursing homes residents show Palliative Needs regardless of the response to the Surprise Question of the NECPAL tool. Other characteristics such as presence of an intermediate level of frailty are suggested as a new perspective to identify advanced chronic patients among nursing homes residents.
在养老院中进行适当的临终关怀规划需要先进的护理需求知识，以了解居民的需求。本研究旨在评估临终关怀需求以及脆弱性、复杂性和预后等其他条件，并提出新的指标，以确定居民的先进慢性病状况。
对 149 家养老院的复杂慢性病居民进行了横断面研究，由经过培训的专业人员进行评估。通过综合评估评估临终关怀需求，使用 NECPAL ICO-CCOMS©工具评估，脆弱性、病例和临终关怀复杂性和预后进行评估。进行描述性分析和关联度量，将统计显著性设置为 0.05。
超过 50%的居民有积极的意外问题和其他临终关怀需求，并被归类为先进的慢性患者。居民最常见的需求是痛苦和/或严重适应障碍，在积极和消极意外问题组之间发现了脆弱性和其他特征水平的显著差异。两个组之间的方面也存在统计学上显著的相关性。
养老院居民表现出临终关怀需求，无论他们对 NECPAL 工具的意外问题的反应如何。其他特征，如中度脆弱性的存在，被认为是识别养老院居民中先进慢性病患者的新视角。
