EAPC - ipac

444 EAPC Abstracts
Jason Boland University of Sheffield Sheffield UNITED KINGDOM
Georgina Keenleyside University of Sheffield Sheffield UNITED KINGDOM
Sophie Harrison University of Sheffield Sheffield UNITED KINGDOM
Sam Ahmedzai University of Sheffield Sheffield UNITED KINGDOM
Richard Stevens University of Sheffield Sheffield UNITED KINGDOM
Sam Kyeremateng University of Sheffield Sheffield UNITED KINGDOM
Background: There is a plethora of chronic pain assessment methods and
scales that are used across a wide range of care settings. Specialist pain
scoring systems are used, for example, in cancer service, pain clinics,
arthritis care and nursing homes. There are also different tools for children
and older people, including those with dementia. Each service uses
different measures which can reduce effective communication. There
should be some standardisation so that the best evidence-based measures
are used consistently across services. Aims: To describe the best practice
in the assessment of chronic pain in adults and older children and to make
recommendations for a standardised approach for use in the UK National
Health Service. The project was part of an NHS programme to engage and
enable clinicians, healthcare providers and patients to share their knowledge,
skills, and experiences. Methods: Two national stakeholder events
have taken place. The project has sought opinions from a wide range of
experts, patient representatives and professional bodies. A systematic
extensive search of the literature was performed. All key documents and
feedback from the events have been posted on the National Library for
Palliative and Supportive Care website. An email discussion page was set
up to facilitate discussion around this topic. Results: The literature review
has identified over 150 pain assessment instruments. We have categorised
these according to age group; cognitive functioning; body systems;
disease types. Recommendations for standardised use in different settings
are being disseminated for consultation. Conclusions: The assessment of
chronic pain is complex and clearly requires a wide range of measures.
The project has for the first time produced a comprehensive classification
and sets of logical recommendations for clinicians and researchers. These
now need to be widely consulted and incorporated into clinical data
management systems.
Poster N°: 149
Type of presentation: Poster
Poster session: First Group 29 May Thursday, 10.30 to 30 May Friday
13.00
Category: Assessment & measurement tools
Title: Mini-Suffering State Examination scale: possible key criterion for
6 months survival and mortality of critically ill dementia patients
Authors:
Bechor Zvi Aminoff Geriatric Division Sheba Medical Center,
Tel-Hashomer ISRAEL
Background: Six months of survival as a key criterion is extremely important
for decision-making for enrolling critically ill patients to palliative settings.
Prospective cohort study with 6 months of follow-up during a
24-month period performed in Division of Geriatric Medicine in a tertiary
general hospital. Methods: One-hundred and three consecutively admitted
bedridden patients with end-stage dementia were evaluated. Patients were
evaluated weekly by the Mini Suffering State Examination scale (MSSE)
which developed by us and presented in world and regional congresses in
Berlin (1999), Jerusalem (2000), Vancouver (2001), Stockholm (2002),
Tokyo (2003), Las-Vegas (2004), Rio-de-Janeiro (2005), Madrid (2006),
Saint-Petersburg (2007), the Committee for Labor, Social Services and
Health of the Israeli Knesset (2005) and published in Journal Archives of
Gerontology and Geriatrics (2004, 38, 2, 123–130) and Age and Ageing
(2006, 35, 6, 597–601) and our book – Measurement of Suffering in endstage
Alzheimer’s Disease, Dyonon, Tel-Aviv, 2007. Interrelations between
Mini-Suffering State Examination score at admission and six month’s survival
and mortality were evaluated. Results: A significant difference was
proved among survival curves of subgroups of patients according to the
mini scores (0–3, 4–6, 7–10). Survival was shorter and mortality higher in
patients with a high Mini-Suffering State Examination score, as shown by
the Kaplan-Meier method using the Log Rank (p=0.001) and Breslow tests
(p=0.001). Conclusions: The Mini-Suffering State Examination scale is
useful for predicting the last 6 months of survival and mortality of end-stage
dementia patients.
Poster N°: 150
Type of presentation: Poster
Poster session: First Group 29 May Thursday, 10.30 to 30 May Friday
13.00
Category: Assessment & measurement tools
Title: Caregiver’s perspective of quality: development of a satisfaction tool
Presenting author: Annette Welshman
Authors:
Francesca Bordin Palliative Care Unit Fondazione Sue Ryder Onlus ITALY
Francesca Trasatti Fondazione Sue Ryder Onlus Roma ITALY
Annette Welshman Fondazione Sue Ryder Onlus Roma ITALY
Background: Carer satisfaction is a crucial outcome measure in Palliative
Care. Satisfaction measurement tools in end of life care are few; a literature
review identified 20 potential instruments for consideration in a PC
setting. A 12 month pilot study in a palliative care population aimed at
evaluating a new comprehensive tool was developed on the basis of a previously
reported experience, in terms of usefulness and audit aims.
Methods: An anonymous self-administered questionnaire was sent to the
carer/family approximately 30 days following pt’s death. 20 items where
chosen based on the model of FAMCARE, modified on-going in focus
groups, tailored for the dying population and adapted to a home-hospice
care setting: 17 are 5-point scales, and 3 Yes/No/Don’t know response
options. Distinct areas of care were tested: Organisational:
(accessibility/admission procedures/staff-care coordination); Technical:
(competency/physical-psychological symptoms control/place of death);
Relational: (respect/communication/support-family involvement in decision
making); Overall satisfaction/response to expectation.; The opportunity
to write feelings/advice was encouraged. Results: Response rate was
58%, lower than the previous instrument used (61%), maybe due to a
greater time requirement and emotional implication in filling in the form.
Overall care satisfaction discriminated well between excellent 74,7%, and
satisfactory 21,6%: place of death was respondent to pt/carer choice in
>90%, and 96,4% reported care as fully respondent to their expectation.
Separate subscale analysis revealed more satisfaction for relational than for
organisational/technical aspects, showing some difficulties in “excellent”
symptom control. Among relational issues, respect /attention were more
satisfactory than information/communication, and the need for more specialist
psychological support was underlined. Conclusion: The tool is a
simple and useful audit tool; subscales evaluation and sources of “dissatisfaction”
assists in planning and implementing change.
Poster N°: 151
Type of presentation: Poster
Poster session: First Group 29 May Thursday, 10.30 to 30 May Friday
13.00
Category: Assessment & measurement tools
Title: Validity of an average 8-hour pain intensity assessment in cancer
patients
Presenting author: Cinzia Brunelli
Authors:
Augusto Caraceni National Cancer Institute Rehabilitation and Pallliative
Care Unit ITALY
Ernesto Zecca National Cancer Institute Milan ITALY
Cinzia Brunelli National Cancer Institute Milan ITALY
Cinzia Martini National Cancer Institute Milan ITALY
Giovanna Gorni National Cancer Institute Milan ITALY