Year 2018 / Volume 25 / Number 4

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Original

The demoralisation syndrome. An estimation of its prevalence in patients receiving palliative care at home

Med Paliat. 2018;25(4):255-259

Daniel Ramos Pollo , Álvaro Sanz Rubiales, Martín L. Vargas, José Antonio Mirón Canedo, Montserrat Alonso Sardón y Manuel González Sagrado


ABSTRACT

Objective: The demoralisation syndrome (DS) is a psycho-emotional situation characterized by despair, helplessness, loss of meaning, and existential distress. We intend to establish the prevalence of DS in advanced patients treated by a Palliative Care Team in our setting.

Methodology: We included 100 consecutive advanced patients treated at home by a Palliative Care Team. To be included we required informed consent, and adequate physical and neuropsychological conditions to complete a semi-structured interview and the questionnaires (ESASr, PPS, Barthel, emotional distress thermometer, HADS). We used Kissane's diagnostic criteria of DS. The study was approved by our Ethics Committee.

Results: Four cases of DS were found, representing a prevalence of 4% (95% CI: 2% to 10%). The characteristics of these patients that were different from the rest of the sample were: age <70 years (P=0.02), university studies (P=0.03), absence of religious attitude (P=0.07), presence of suffering (P=0.01). They also showed greater intensity of symptoms such as asthenia (P=0.01), anxiety (P<0.001), and depression (P=0.07).

Conclusion: In our setting we found a prevalence of DS of only 4% in a population of patients treated by a Home Palliative Care Team. The conditions for entering the study and the use of relatively strict diagnostic criteria may have influenced this result.

Keywords: Palliative care, Adjustment disorders, Death, Psyco-oncology, SufferingDemoralisation

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