Gesell, Daniela; Hodiamont, Farina; Wikert, Julia; Lehmann-Emele, Eva; Bausewein, Claudia; Nauck, Friedemann; Jansky, Maximiliane (2023): Symptom and problem clusters in German specialist palliative home care - a factor analysis of non-oncological and oncological patients’ symptom burden. BMC Palliative Care, 22 (1). ISSN 1472-684X
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Veröffentlichte Publikation
s12904-023-01296-0.pdf

Abstract
Background
Specialist palliative home care (SPHC) aims to maintain and improve patients’ quality of life in the community setting. Symptom burden may differ between oncological and non-oncological patients. However, little is known about diagnosis-related differences of SPHC patients. This study aims to describe the prevalence of physical symptom burden and psychosocial problems of adult patients in SPHC, and to evaluate diagnosis-related symptom clusters.
Methods
Secondary analysis of data from a prospective, cross-sectional, multi-centre study on complexity of patients, registered at the German Register for Clinical Studies (DRKS trial registration number: DRKS00020517, 12/10/2020). Descriptive statistics on physical symptom burden and psychosocial problems at the beginning of care episodes. Exploratory and confirmatory factor analyses to identify symptom and problem clusters.
Results
Seven hundred seventy-eight episodes from nine SPHC teams were included, average age was 75 years, mean duration of episode 18.6 days (SD 19.4). 212/778 (27.2%) had a non-oncological diagnosis. Main burden in non-oncological episodes was due to poor mobility (194/211; 91.9%) with significant diagnosis-related differences (χ² = 8.145, df = 1, p = .004; oncological: 472/562; 84.0%), and due to weakness (522/565; 92.4%) in oncological episodes. Two symptom clusters (psychosocial and physical) for non-oncological and three clusters (psychosocial, physical and communicational/practical) for oncological groups were identified. More patients in the non-oncological group compared to the oncological group showed at least one symptom cluster (83/212; 39.2% vs. 172/566; 30.4%).
Conclusion
Patients with non-oncological diseases had shorter episode durations and were more affected by symptom clusters, whereas patients with oncological diseases showed an additional communicational/practical cluster. Our findings indicate the high relevance of care planning as an important part of SPHC to facilitate anticipatory symptom control in both groups.
Dokumententyp: | Artikel (Klinikum der LMU) |
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Organisationseinheit (Fakultäten): | 07 Medizin > Klinikum der LMU München > Klinik und Poliklinik für Palliativmedizin |
DFG-Fachsystematik der Wissenschaftsbereiche: | Lebenswissenschaften |
Veröffentlichungsdatum: | 09. Feb 2024 08:58 |
Letzte Änderung: | 09. Feb 2024 09:37 |
URI: | https://oa-fund.ub.uni-muenchen.de/id/eprint/1133 |
DFG: | Gefördert durch die Deutsche Forschungsgemeinschaft (DFG) - 491502892 |