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Castro-Rodriguez E, Azagra-Ledesma R, Gómez-Batiste X, Aguyé-Batista A, Clemente-Azagra C, Díaz-Herrera MA. Complexity of needs in amyotrophic lateral sclerosis (ALS) patients using the ENP-E scale in the north-eastern region of Spain. Palliat Support Care 2024:1-10. [PMID: 38294285 DOI: 10.1017/s1478951523001773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
OBJECTIVES This study aimed to explore the clinical characteristics of amyotrophic lateral sclerosis (ALS) patients in Spain's north-eastern region, their inclusion in chronic care programmes, and their psychosocial and spiritual needs (PSNs). METHODS A longitudinal descriptive study in adult patients with ALS. We analyzed clinical variables and participation in chronicity and PSNs assessment using the tool Psychosocial and Spiritual Needs Evaluation scale in end-of-life patients (ENP-E scale). RESULTS 81 patients (average age 65.6 ± 11.7) were studied. At the study's outset, 29.7% employed non-invasive ventilation (NIV), increasing to 51.9% by its conclusion. Initial percutaneous endoscopic gastrostomy (PEG) utilization was 14.8%, rising to 35.85%. Chronic care programme participation was as follows: home care (24.7% initially, 50.6% end), palliative care (16% initially, 40.7% end), case management (13.6% initially, 50.6% end), and advance care planning registration (6.2% initially, 35.8% end). At study start, 47.8% of patients (n = 46) showed moderate-to-severe complexity in PSNs assessment using the ENP-E scale, without showing differences in age, sex, and time of evolution; whereas, on the evolutionary analysis, it was 75% (n = 24). A higher evolutionary complexity was observed in males <60 and >70 years, with no PEG and evolution of ALS of <2 and ≥5 years, and not included in chronicity programmes. When assessing concerns, physical pain and family aspects stand out in all measurements. Forty-eight percent of patients at study start and 71% at end of study showed external signs of emotional distress. SIGNIFICANCE OF RESULTS Most ALS patients showed a high degree of complexity and were not integrated in chronicity programmes. A "care path" is proposed to integrate ALS patients in these programmes and systematically assess their needs.
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Affiliation(s)
- Emilia Castro-Rodriguez
- PADES Delta de Llobregat, Institut Català de la Salut, El Prat de Llobregat, Barcelona, Spain
| | - Rafael Azagra-Ledesma
- Medicina de Familia, Centro de Atención Primaria Badía del Vallés, Intitut Català de la Salut, Badia del Vallès, Barcelona, Spain
- Departamento de Medicina, Universitat Autònoma de Barcelona (UAB), Bellaterra, Barcelona, Spain
- GROIMAP/GROICAP, USR Girona IDIAP Jordi Gol, Girona, Spain
- Fundación Privada PRECIOSA para la Investigación en Salud, Barberá del Vallés, Barcelona, Spain
| | - Xavier Gómez-Batiste
- Cátedra de Cuidados Paliativos, Centre d'Estudis Sanitaris i Socials (CESS), Universitat de Vic - Universitat Central de Catalunya (UVIC-UCC), Vic, Barcelona, Spain
| | - Amada Aguyé-Batista
- Departamento de Medicina, Universitat Autònoma de Barcelona (UAB), Bellaterra, Barcelona, Spain
- GROIMAP/GROICAP, USR Girona IDIAP Jordi Gol, Girona, Spain
- Medicina de Familia, Centro de Atención Primaria Granollers Vallés Oriental, ICS, Granollers, Barcelona, Spain
| | - Carlos Clemente-Azagra
- Employers Mutual Limited-EML Corporate Office, Sydney, NSW, Australia
- School of Health Sciences, University of Newcastle, University Drive, Callaghan, NSW, Australia
| | - Miguel Angel Díaz-Herrera
- Complex Wounds South Metropolitan Primary Care, Institut Català de la Salut, L'Hospitalet de Llobregat, Barcelona, Spain
- Department of Fundamental and Clinical Nursing, Faculty of Nursing, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
- Teaching Committee, Quironsalud Hospital Universitari General de Catalunya, Sant Cugat del Vallès, Barcelona, Spain
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