Development and Validation of the Symptom Assessment to Improve Symptom Control for Institutionalized Elderly Scale
| Autor: | Nele Van Den Noortgate, Maaike L De Roo, Marc Tanghe, Ruth Piers |
|---|---|
| Přispěvatelé: | Family Medicine and Chronic Care, End-of-life Care Research Group |
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Delphi Technique Intraclass correlation Nursing(all) symptom assessment tool 03 medical and health sciences 0302 clinical medicine Interquartile range Pain assessment frail older persons Journal Article Humans Medicine Geriatric Assessment General Nursing Aged Aged 80 and over symptom assessment business.industry Health Policy Construct validity General Medicine Intra-rater reliability symptom control Nursing Homes Test (assessment) nursing home 030220 oncology & carcinogenesis Mann–Whitney U test Physical therapy Population study Female Geriatrics and Gerontology business 030217 neurology & neurosurgery |
| Zdroj: | Journal of the American Medical Directors Association. 19:148-153.e5 |
| ISSN: | 1525-8610 |
| Popis: | Objectives To validate a newly developed multiple symptom self-assessment tool in nursing homes. Design Thirty prevalent symptoms identified in the literature were classified by a 2-round Delphi procedure to a top 10 of the most relevant, burdensome symptoms. Because no existing symptom scale fully covered this top 10, we developed a new scale, consisting of a horizontal numerical scale for the top 10 symptoms, with the possibility to add and rate 3 other symptoms. This scale was validated. Setting and participants Hundred seventy-four participants, mean age 85 (±5.94) years, were recruited from 7 nursing homes (86%) and 3 acute geriatric wards (14%). Methods To test the construct validity, participants with and without a palliative status were enrolled. Participants completed the Symptom Assessment to Improve Symptom Control for Institutionalized Elderly (SATISFIE) scale on day 0 and day 1 (intrarater reliability). Nurses completed the scale on day 0 (inter-rater reliability). Descriptive statistics described the characteristics of the study population and symptom scores. Differences in symptom scores between palliative and nonpalliative participants were analyzed with the Mann-Whitney U test. Intrarater and inter-rater reliability were calculated by means of an intraclass correlation coefficient. Factor analysis searched for possible symptom clusters. Feasibility was evaluated by measuring the assessment time and by providing a questionnaire for the nurses. Results In the nonpalliative group (n = 130), the highest self-rated median scores were pain on day 1 [median 3, interquartile range (IQR) 0–5] and pain on day 2. In the palliative group (n = 44), the highest median self-rated scores were fatigue on day 1 [median 5 (IQR 0–6)], lack of energy on day 1 and 2 [both median 5 (IQR 0–8)]; and depressed feeling on day 2 [median 3 (IQR 0–5)]. Nurse assessments median scores were the highest for depressed feeling [median 5 (IQR 1–7)], fatigue [median 4.5 (IQR 0–6.5)], and lack of energy, [median 3 (IQR 0–6)] in the palliative group. In the nonpalliative group, none of the median scores was 3 or more. Intraclass correlation coefficients for intrarater reliability varied between 0.65 and 0.89 and for inter-rater reliability (patients-nurses) between 0.18 and 0.63. Mean assessment time for nurses was 2.0 minutes [standard deviation (SD) = 1.01]. For participants, it decreased from 10.5 minutes (SD = 5.41) at the first assessment to 7.5 minutes (SD = 3.72) at the second assessment. Nurses determined the SATISFIE instrument to be useful, applicable in daily practice, and sufficiently comprehensible for the patients. Conclusions The SATISFIE scale is a valid and feasible instrument for regular, multiple symptom assessment in institutionalized older persons. |
| Databáze: | OpenAIRE |
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