Palliative Care Needs of Elderly Patients Hospitalized in Internal Medicine Departments

Postgraduate Thesis uoadl:2896415 298 Read counter

Unit:
Κατεύθυνση Οργάνωση & Διαχείριση ανακουφιστικής & υποστηρικτικής φροντίδας χρονίως πασχόντων
Library of the School of Health Sciences
Deposit date:
2020-02-03
Year:
2020
Author:
Chatzi Ioanna
Supervisors info:
Στυλιανός Κατσαραγάκης, Επίκουρος Καθηγητής, Τμήμα Νοσηλευτικής. ΕΚΠΑ, Επιβλέπων
Ελισάβετ Πατηράκη, Καθηγήτρια, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Παναγιώτα Σουρτζή, Καθηγήτρια, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Original Title:
Ανάγκες Ανακουφιστικής Φροντίδας ηλικιωμένων ασθενών που νοσηλεύονται σε παθολογικά τμήματα
Languages:
Greek
Translated title:
Palliative Care Needs of Elderly Patients Hospitalized in Internal Medicine Departments
Summary:
Introduction: The elderly (above 65 years) have become the leading population of our society. Their multitude of healthcare chronic problems demands palliative care (PC) and therefore PC needs assessment. Objective: To examine the PC problems and needs for professional help of hospitalized elderly patients. Methods: A quantitative study using structured questionnaires [PNPC, Mini – Mental State Examination (MMSE), EORTCQLQ - C15 – PAL, Clinical Frailty Scale, Cumulative Illness Rating Scale for Geriatrics – CIRS-G, demographic and clinical characteristics] was conducted through December 2018 – February 2019, at internal medicine wards of a public general hospital. Patients with MMSE<24, at the end of life and with recent surgery were excluded. A translated in Hellenic language shortform version of PCPN was. The PCPN-SV is a 33 items 3-point Likert type scale that covers 8 domains: Activities of daily living (ADL/IADL), Physical symptoms (PS), Autonomy (A), Social (SI), Psychological (PI), Spiritual issues (Sp), Financial problems (FP) and Need for information (NI). The level of statistical significance was set at 0.05. The left-hand column measures on a 3-point Likert-type scale (0-2) whether patients experience the problem described in the question and the righthand column measures patients' desire for professional help in their problem. Also used were "EORTC QLQ - C15 - PAL" for quality of life assessment, "Mini - Mental State Examination" for measuring mental status, "Clinical Frailty Scale" for assessing the vulnerability of elderly patients and "Cumulative Illness Rating Scale For Geriatrics - CIRS-G" for assessment of morbidity per organ system. Finally, the patients' medical and nursing records provided data to complete the demographic and clinical data form created for this study. Results: A convenience sample of 150 patients was recruited. Their age was 75,7 years (range 65-94). Male patients accounted for 50.7% of the sample. The mean value of participants' mental state (MMSE) was 27.4. The most important problem for which patients expressed a need for professional help was information (79.3%). Other problems are sleep disorders (89%), pain (86%), fear and depression (85%). Need for professional help was expressed for sleep disorders (91%), pain (85%) and fatigue (81%). An important finding of the present study was the correlations of the degree of frailty to both problems and needs for professional help with permanent caregiver, organizational symptoms, autonomy, social, psychological, spiritual, and financial issues and the need for information. It appears, therefore, that patients with higher scores on the frailty scale place greater emphasis on organic symptoms, autonomy, social, psychological, spiritual and financial issues and on information as opposed to those who score less on the frailty scale. Finally, significant correlations were found between almost all dimensions of problems and needs of palliative care and quality of life (p<0,001). Better quality of life and fewer symptoms are associated with fewer problems and needs for professional help in the PNPC areas. Conclusions: Elderly hospitalized patients have a variety of symptoms and problems at a physical, economical, social, psychological and spiritual level. In addition, there is insufficient patient information on their health condition and on their treatment options. Elderly patients need palliative care and appropriately trained health professionals to address their problems and fulfil their needs.
Main subject category:
Health Sciences
Keywords:
Palliative care needs, Elderly, Hospitalized
Index:
No
Number of index pages:
0
Contains images:
Yes
Number of references:
173
Number of pages:
179
ΧΑΤΖΗ ΔΙΠΛΩΜΑΤΙΚΗ.pdf (5 MB) Open in new window