End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Laarbeeklaan 103, 1090, Brussels, Belgium.
Department of Geriatric Medicine, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
BMC Palliat Care. 2022 Oct 6;21(1):173. doi: 10.1186/s12904-022-01065-5.
Little is known about the nature and intensity of palliative care needs of hospitalised older people. We aimed to describe the palliative care symptoms, concerns, and well-being of older people with frailty and complex care needs upon discharge from hospital to home, and to examine the relationship between palliative care symptoms and concerns, and well-being.
Cross-sectional study using baseline survey data of a pilot randomised controlled trial. Hospital staff identified patients (≥ 70 years) about to be discharged home, with a clinical frailty score of 5 to 7 and complex needs based on physician-assessment. Patients completed structured interviews, using the Integrated Palliative Care Outcome Scale (IPOS), ICEpop CAPability measure for supportive care (ICECAP-SCM) and IPOS Views on Care quality of life item. We calculated descriptive statistics.
We assessed 37 older people with complex needs (49% women, mean age 84, standard deviation 6.1). Symptoms rated as causing severe problems were weakness (46%) and poor mobility (40%); 75% reported that their family felt anxious at least occasionally. Of the 17 IPOS items, 41% of patients rated five or more symptoms as causing severe problems, while 14% reported that they were not severely affected by any symptom. 87% expressed feeling supported. There was a negative correlation between symptoms (IPOS) and well-being (ICECAP); r = -0.41.
We identified a large variety of symptoms experienced by older people identified as having frailty and complex needs upon hospital discharge. Many were severely affected by multiple needs. This population should be considered for palliative care follow-up at home.
对于住院老年人的姑息治疗需求的性质和强度知之甚少。我们旨在描述虚弱和复杂护理需求的老年人出院后姑息治疗的症状、关注点和幸福感，并探讨姑息治疗症状和关注点与幸福感之间的关系。
这是一项使用试点随机对照试验基线调查数据的横断面研究。医院工作人员确定了即将出院回家的患者（≥70 岁），他们的临床虚弱评分为 5-7 分，且根据医生评估存在复杂需求。患者使用综合姑息治疗结局量表（IPOS）、ICEpop CAPability measure for supportive care（ICECAP-SCM）和 IPOS 护理质量生活项目进行了结构访谈。我们计算了描述性统计数据。
我们评估了 37 名有复杂需求的老年人（49%为女性，平均年龄 84 岁，标准差 6.1）。被评为导致严重问题的症状有：虚弱（46%）和行动不便（40%）；75%的患者报告说他们的家人至少偶尔会感到焦虑。在 17 项 IPOS 项目中，41%的患者将五项或更多症状评为导致严重问题，而 14%的患者表示他们没有受到任何症状的严重影响。87%的患者表示感到得到了支持。症状（IPOS）与幸福感（ICECAP）之间呈负相关；r = -0.41。
我们发现，出院时被确定为虚弱和有复杂需求的老年人存在多种症状，其中许多人受到多种需求的严重影响。这一人群应该考虑在家庭中接受姑息治疗随访。
