Declive funcional y presencia de síntomas en cuidados paliativos: ¿causa o consecuencia?
Zamora-Mur, Alfredo (Universidad de Zaragoza) ; Nabal-Vicuña, María ; Zamora-Catevilla, Aranzazu ; García-Foncillas, Rafael (Universidad de Zaragoza) ; Calderero-Aragón, Verónica ; Aubí-Catevilla, Oscar ; Lostalé-Latorre, Fernando (Universidad de Zaragoza)
Resumen: Introducción: Diversas publicaciones han relacionado el declive funcional con la aparición de síntomas,especialmente psicológicos o psiquiátricos, como ansiedad y depresión. Por otra parte, un trastorno depre-sivo inicial o previo al declive funcional también suele empeorarlo. Nos planteamos conocer la relaciónentre la existencia de declive funcional medido mediante descenso en índice de Barthel (IB) y la presenciade síntomas.
Material y métodos: Estudio analítico prospectivo con los pacientes derivados a un Equipo de Soportepara Atención Domiciliaria (ESAD).Resultados: Seiscientos treinta y ocho casos, 53,9% (N = 344) hombres, 56% (N = 357) oncológicos y 44%(N = 281) no oncológicos. La edad media fue 79,64 ± 10,8 a˜nos. Obtuvimos diferencias significativas(p < 0,001) en declive funcional medido mediante descenso medio en el IB entre pacientes oncológicos(34,4) y no oncológicos (12,12). Encontramos diferencias significativas (p < 0,001) en todos los sínto-mas registrados (dolor, disnea, anorexia, náuseas, ansiedad, depresión e insomnio) con mayor frecuenciaen pacientes oncológicos, salvo en el caso de la agitación psicomotriz. En pacientes con mayor grado dedeclive funcional, con descensos en IB superior a 20 puntos, se detectó mayor presencia de síntomas. Salvodeterminados analgésicos, no hubo diferencias en los tratamientos previos; sí encontramos diferenciasen diversos tratamientos pautados por el ESAD.
Conclusiones: La existencia de declive funcional y su grado pueden verse relacionados con la apariciónde síntomas, especialmente en el paciente oncológico.
Introduction
Several publications have related functional decline to the appearance of symptoms, especially psychiatric or psychological ones, such as anxiety and depression. Moreover, an initial depressive disorder or prior to functional decline usually worsens it. It was decided to investigate the relationship between the presence of functional decline, measured by a decrease in the Barthel index (BI), and the presence of symptoms.
Material and methods
A prospective analytical study conducted on patients referred to a Home Care Support Team (HCST).
Results
The study included 638 cases, of which 53.9% (N = 344) were male, 56% (N = 357) with cancer and 44% (N = 281) geriatric. The mean age was 79.64 years + - 10.8. Significant differences (P<.001) were found in functional decline measured by mean decline in the BI between cancer (34.4) and non-cancer patients (12.12). Significant differences (P<.001) were also found in all recorded symptoms (pain, dyspnoea, anorexia, nausea, anxiety, depression, and insomnia), more frequently in cancer patients, except psychomotor agitation. A higher presence of symptoms was detected in patients with greater functional decline, with decreases in BI above 20 points. There were no differences in previous treatments, except in certain analgesics. Differences were found in the different treatments prescribed by HCST.
Conclusions
The presence of functional decline and its level may be related to the appearance of symptoms, especially in cancer patients.
Idioma: Español
DOI: 10.1016/j.regg.2016.10.004
Año: 2017
Publicado en: Revista Espanola de Geriatria y Gerontologia 52, 3 (2017), 142-145
ISSN: 0211-139X
Factor impacto SCIMAGO: 0.225 - Geriatrics and Gerontology (Q3) - Medicine (miscellaneous) (Q3) - Aging (Q4)
Tipo y forma: Article (PostPrint)
Área (Departamento): Area Histología (Dpto. Anatom.Histolog.Humanas)
Área (Departamento): Area Anatom.Embriol.Humana (Dpto. Anatom.Histolog.Humanas)
Área (Departamento): Área Medic.Prevent.Salud Públ. (Dpto. Microb.Med.Pr.,Sal.Públ.)
You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes. If you remix, transform, or build upon the material, you may not distribute the modified material.
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Material y métodos: Estudio analítico prospectivo con los pacientes derivados a un Equipo de Soportepara Atención Domiciliaria (ESAD).Resultados: Seiscientos treinta y ocho casos, 53,9% (N = 344) hombres, 56% (N = 357) oncológicos y 44%(N = 281) no oncológicos. La edad media fue 79,64 ± 10,8 a˜nos. Obtuvimos diferencias significativas(p < 0,001) en declive funcional medido mediante descenso medio en el IB entre pacientes oncológicos(34,4) y no oncológicos (12,12). Encontramos diferencias significativas (p < 0,001) en todos los sínto-mas registrados (dolor, disnea, anorexia, náuseas, ansiedad, depresión e insomnio) con mayor frecuenciaen pacientes oncológicos, salvo en el caso de la agitación psicomotriz. En pacientes con mayor grado dedeclive funcional, con descensos en IB superior a 20 puntos, se detectó mayor presencia de síntomas. Salvodeterminados analgésicos, no hubo diferencias en los tratamientos previos; sí encontramos diferenciasen diversos tratamientos pautados por el ESAD.
Conclusiones: La existencia de declive funcional y su grado pueden verse relacionados con la apariciónde síntomas, especialmente en el paciente oncológico.
Introduction
Several publications have related functional decline to the appearance of symptoms, especially psychiatric or psychological ones, such as anxiety and depression. Moreover, an initial depressive disorder or prior to functional decline usually worsens it. It was decided to investigate the relationship between the presence of functional decline, measured by a decrease in the Barthel index (BI), and the presence of symptoms.
Material and methods
A prospective analytical study conducted on patients referred to a Home Care Support Team (HCST).
Results
The study included 638 cases, of which 53.9% (N = 344) were male, 56% (N = 357) with cancer and 44% (N = 281) geriatric. The mean age was 79.64 years + - 10.8. Significant differences (P<.001) were found in functional decline measured by mean decline in the BI between cancer (34.4) and non-cancer patients (12.12). Significant differences (P<.001) were also found in all recorded symptoms (pain, dyspnoea, anorexia, nausea, anxiety, depression, and insomnia), more frequently in cancer patients, except psychomotor agitation. A higher presence of symptoms was detected in patients with greater functional decline, with decreases in BI above 20 points. There were no differences in previous treatments, except in certain analgesics. Differences were found in the different treatments prescribed by HCST.
Conclusions
The presence of functional decline and its level may be related to the appearance of symptoms, especially in cancer patients.
Idioma: Español
DOI: 10.1016/j.regg.2016.10.004
Año: 2017
Publicado en: Revista Espanola de Geriatria y Gerontologia 52, 3 (2017), 142-145
ISSN: 0211-139X
Factor impacto SCIMAGO: 0.225 - Geriatrics and Gerontology (Q3) - Medicine (miscellaneous) (Q3) - Aging (Q4)
Tipo y forma: Article (PostPrint)
Área (Departamento): Area Histología (Dpto. Anatom.Histolog.Humanas)
Área (Departamento): Area Anatom.Embriol.Humana (Dpto. Anatom.Histolog.Humanas)
Área (Departamento): Área Medic.Prevent.Salud Públ. (Dpto. Microb.Med.Pr.,Sal.Públ.)
You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes. If you remix, transform, or build upon the material, you may not distribute the modified material. Exportado de SIDERAL (2019-07-09-11:52:35)
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Record created 2018-12-19, last modified 2019-07-09