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Palliat Support Care. 2016 Jun;14(3):278-83. doi: 10.1017/S1478951515000942. Epub 2015 Aug 3.

Assessment of discomfort in patients with cognitive failure in palliative care.

Author information

1
Palliative Care Service,Portuguese Institute of Oncology,Porto,Portugal.
2
Hospital de Matosinhos,Matosinhos,Portugal.
3
Hospital de Santa Maria da Feira,Santa Maria da Feira,Portugal.

Abstract

OBJECTIVE:

When cognitive impairment precludes patients' report of symptoms, it becomes necessary to use other means. The purpose of our study was to evaluate the validity of the method currently in use on our service.

METHOD:

Two members of the team simultaneously assessed the patient and independently recorded whether the patient showed signs of discomfort, and a third questioned patients with cognitive failure who maintained some ability to respond if something was bothering them.

RESULTS:

Some 200 assessments were made of 116 patients. The kappa coefficient of agreement was 0.615. The sensitivity was 17% and specificity 99%. The positive predictive value was 88%, and the negative predictive value was 73%.

SIGNIFICANCE OF RESULTS:

Due to the low sensitivity of this method, it cannot be recommended as a screening tool.

KEYWORDS:

Assessment tools; Cognitive Failure; Discomfort assessment; Palliative care

PMID:
26235603
DOI:
10.1017/S1478951515000942
[Indexed for MEDLINE]
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