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

Published online by Cambridge University Press:  03 August 2015

José António Ferraz Gonçalves Open the ORCID record for José António Ferraz Gonçalves [Opens in a new window] ,
Elisabete Costa ,
Natércia Edra ,
João Gil ,
Carla Martinho ,
Emília Neves ,
Vânia Peixoto ,
Andreia Rodrigues ,
Margarida Silva  and
Sara Teixeira
José António Ferraz Gonçalves*
Affiliation:
Palliative Care Service, Portuguese Institute of Oncology, Porto, Portugal
Elisabete Costa
Affiliation:
Palliative Care Service, Portuguese Institute of Oncology, Porto, Portugal
Natércia Edra
Affiliation:
Palliative Care Service, Portuguese Institute of Oncology, Porto, Portugal
João Gil
Affiliation:
Hospital de Matosinhos, Matosinhos, Portugal
Carla Martinho
Affiliation:
Palliative Care Service, Portuguese Institute of Oncology, Porto, Portugal
Emília Neves
Affiliation:
Palliative Care Service, Portuguese Institute of Oncology, Porto, Portugal
Vânia Peixoto
Affiliation:
Hospital de Santa Maria da Feira, Santa Maria da Feira, Portugal
Andreia Rodrigues
Affiliation:
Palliative Care Service, Portuguese Institute of Oncology, Porto, Portugal
Margarida Silva
Affiliation:
Palliative Care Service, Portuguese Institute of Oncology, Porto, Portugal
Sara Teixeira
Affiliation:
Palliative Care Service, Portuguese Institute of Oncology, Porto, Portugal
*
Address correspondence and reprint requests to José António Ferraz Gonçalves, Palliative Care Service, Portuguese Institute of Oncology, Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal. E-Mail: [email protected] or [email protected].
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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

Palliative careCognitive FailureAssessment toolsDiscomfort assessment
Type
Original Articles
Information
Palliative & Supportive Care , Volume 14 , Issue 3 , June 2016 , pp. 278 - 283
Copyright
Copyright © Cambridge University Press 2015 

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Footnotes

*

Adapted from: Inouye et al. (1990). © Copyright 2003, Sharon K. Inouye, M.D., M/P/H.

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