Browsing by Author "Bonati, Pilar"

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    Frecuencia y pesquisa de síntomas en pacientes crónicos en fases avanzadas en un hospital clínico. ¿Existe concordancia entre pacientes y médicos?
    (2008) Palma Behnke, María Alejandra; Del Río Silva, María Ignacia; Bonati, Pilar; Tupper Satt, Laura; Villarroel del Pino, Luis A.; Olivares Osorio, Patricia Carolina; Nervi, Flavio
    Background: Physicians tend to over or underestimate symptoms reported by patients. Therefore standardized symptom scoring systems have been proposed to overcome this drawback. Aim: To estimate the prevalence and the diagnostic accuracy of physical and psychological symptoms and delirium in patients admitted to an internal medicine service at a university hospital. Material and Methods: We studied 58 patients, 45 with metastasic cancer and 13 with other advanced chronic diseases. The following scales were used: the Confusion Assessment Method for the diagnosis of delirium; the Edmonton Symptom Assessment Scale (ESAS) for pain and other physical symptoms; the Hospital Anxiety and Depression Scale to assess anxiety and depression. The ESAS was simultaneously applied to patients without delirium and their doctors to assess the level of diagnostic concordance. Results: Twenty two percent of patients had delirium. Among the 45 patients without delirium, 11 (25%) had at least eight symptoms and 39 (88.6%) had four symptoms. The prevalence of symptoms was very high, ranging from 22 to 78%. Pain, restlesness, anorexia and sleep disorders were the most common. The concordance between symptoms reported by patients and those recorded by doctor was very low, with a Kappa index between 0.001 and 0.334. Conclusions: In our sample of chronic patients, there is a very high frequency of psychological and physical symptoms that are insufficiently recorded by the medical team.
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    Spiritual Pain Is Associated with Decreased Quality of Life in Advanced Cancer Patients in Palliative Care: An Exploratory Study
    (2019) Perez-Cruz, Pedro E.; Langer, Paola; Carrasco, Cecilia; Bonati, Pilar; Batic, Bogomila; Tupper Satt, Laura; Gonzalez Otaiza, Marcela
    Background: Improving quality of life (QOL) is important in cancer palliative care (PC) patients. "Spiritual pain" (SP) is common in this population, but it is unknown how it affects QOL. Objective: To study the associations between SP and QOL in cancer patients in PC. Design: Cross-sectional. Settings/Subjects: Cancer patients assessed at a PC clinic in Puente Alto, Chile, were enrolled in a longitudinal study to characterize patients' end of life. Inclusion criteria included age >= 18, a primary caregiver, not having delirium, and a Karnofsky performance status (KPS) <= 80. Measurements: After consenting patients completed baseline surveys that included demographics, single-item questions to assess SP (0-10), financial distress, spirituality-related variables and questionnaires to assess QOL (0-100), and physical (Global distress score-physical) and psychological distress (Hospital Anxiety and Depression Scale), baseline data analyses to explore associations between SP and QOL were adjusted for potential confounders. Results: Two hundred and eight patients were enrolled: mean age was 64, 50% were female, and 67% had SP. In univariate analysis, SP was significantly associated with lower QOL (coefficient [95% confidence interval]: -1.88 [-2.93 to -0.84], p < 0.001). Lower QOL was also associated with being younger, lower KPS, higher physical distress, having anxiety or depression, and decreased religiosity and religious coping. In the multivariate analysis, QOL remained independently associated with SP (-1.25 [-2.35; to -0.15], p < 0.026), religious coping (11.74 [1.09 to 22.38], p < 0.031), and physical distress (-0.52 [-0.89 to -0.16], p < 0.005). Conclusions: SP is associated with QOL in cancer patients in PC. SP should be regularly assessed to plan for interventions that could impact QOL. More research is needed.
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    Validation of the Spanish Version of the Quality of Dying and Death Questionnaire (QODD-ESP) in a Home-Based Cancer Palliative Care Program and Development of the QODD-ESP-12
    (2017) Pérez Cruz, Pedro; Oslando Padilla Pérez; Bonati, Pilar; Thomsen Parisi, Oliva; Tupper Satt, Laura; González Otaiza, Marcela; Ceballos Yáñez, Diego; Maldonado Morgado, Armando