Psychosocial needs of residents and family members in residential care facilities: perspective of the care team and associated factors.
Isabel De la Fuente Cruz1, Meritxell Naudeillo Cosp1, Nuria López Matons2
1EAPS Mutuam, . 2CRiD. Grup Mutuam ,
Introduction and Objective: In our country, little is known about end-of-life processes and palliative care in Nursing Homes (NH). The objective of this study is to describe the psychosocial care needs of residents and their families, according to the NH team, and to analyze associated factors. Method: Retrospective descriptive study. Four NH were selected through non-probabilistic convenience sampling. The psychologist conducted two meetings with each team. In these meetings, responses to the “surprise question” from the NECPAL CCOMS-ICO© instrument were collected, along with the perception of whether any residents or family members could benefit from psychosocial care interventions. The two main reasons for requiring intervention were classified using an ad hoc questionnaire. The psychologist also recorded data extracted from the shared clinical history of Catalonia and the NH, including demographic variables, complexity, cognitive status (Short Portable Mental State Questionnaire, emotional (Geriatric Depression Scale), whether an advance directive document was available, and whether residents received family visits. Results: Data from 375 residents were analyzed, with a mean age of 85.15 ± 9.57 years, 71.2% women. Of these, 43.47% presented palliative care needs according to positive response to the ‘surprise question’, and 54.4% of residents and 16% of their relatives were perceived as requiring psychosocial care. Statistically significant differences in psychosocial care needs were found among residents according to cognitive status assessed with the Short Portable Mental State Questionnaire (Mean errors (yes)=7,05±2,92 vs Mean errors (no)=5,72±3,26) and emotional status assessed with the Geriatric Depression Scale (Yesavage) (Mean Score (yes)=6,95±2,69 vs Mean score (no)=5,36±2,67; p=0,001). Conclusion: The high prevalence of psychosocial care needs among residents, and to a lesser extent among their relatives, together with their association with cognitive and emotional impairment, highlights the importance of systematic identification and comprehensive management of these needs in nursing homes.
DOI: 10.20986/medpal.2026.1393/2023
Malignant Psoas Syndrome: Importance of Interdisciplinary Management
Araceli Sánchez Sánchez1, Miriam López Gómez2, David L. Castanheira de Almeida Sobrinho3, Elisa Maxiá López4
1Equipo de soporte de cuidados paliativos. Hospital Universitario Infanta Sofía, San Sebastián de los Reyes. 2Oncología médica. Hospital Universitario Infanta Sofía, San Sebastián de los Reyes. 3Oficina regional de coordinación de cuidados paliativos de la Comunidad de Madrid, . 4Centro asistencial San Camilo. Fundación La Caixa,
Malignant psoas syndrome (MPS) is a rare condition resulting from malignant involvement of the psoas muscle. It is characterized by ipsilateral lumbosacral plexopathy and painful hip flexion and is often refractory to multiple therapeutic approaches. We report the case of a woman with MPS secondary to lymphadenopathy and a soft tissue mass caused by sigmoid adenocarcinoma.
DOI: 10.20986/medpal.2026.1661/2026
Use of clinical ultrasound in advanced cancer patients treated by home-based palliative care teams
Cristina Moran Tiesta1, Adela Vara Serrano2, María Consuelo Fernández Gómez3, Genoveva Díaz Sierra4, Aránzazu Gutiérrez Bermúdez2, Olga Aguilar Huerta5, Ana López Núñez2, Marta Merlo Loranca2, Almudena Seco Fernández6, Nuria Pérez De Lucas7, María Mercedes Portillo Ruiz8, María Félix Ortiz Jiménez:9, Fernando Vicente Sánchez2, Marta García Pérez9, Ana Espejo Gonzalez10, Olga Monclús González2, Diego Ruíz López11, Virginia Vázquez Ramos12, Sergio Collazo Carrera9
1CUIDADOS PALIATIVOS DOMICILIARIOS. ESAPD ESPRONCEDA, Villanueva De la Cañada. 2CUIDADOS PALIATIVOS DOMICILIARIOS. ESAPD CENTRO, Madrid. 3CUIDADOS PALIATIVOS DOMICILIARIOS. ESAPD SUR, Madrid. 4ESAPD SUR, Madrid. 5ESAPD NOROESTE. CS Legazpi, Madrid. 6CUIDADOS PALIATIVOS DOMICILIARIOS. ESAPD NOROESTE, Collado Villaba. 7CUIDADOS PALIATIVOS DOMICILIARIOS. ESAPD SURESTE, . 8CUIDADOS PALIATIVOS DOMICILIARIOS. ESAPD SUERESTE, Madrid. 9CUIDADOS PALIATIVOS DOMICILIARIOS. ESAPD ESTE, Madrid. 10CUIDADOS PALIATIVOS DOMICILIARIOS. ESAPD SUR, Leganes. 11CUIDADOS PALIATIVOS DOMICILIARIOS. ESAPD NOROESTE, Madrid. 12Equipo Soporte de Atención Paliativa Domiciliaria. C. S. Reyes Católicos,
Introduction:
Point-of-care ultrasound (POCUS) has become established as a diagnostic and therapeutic support tool in multiple specialties. In palliative care, its usefulness has been described primarily in the hospital setting, with limited evidence in the home setting, where rapid decision-making and the avoidance of unnecessary transfers are particularly relevant.
Objective: To describe the clinical indications for clinical ultrasound in home-based palliative care, the sociodemographic and functional characteristics of the patients in whom it is used, and to analyze its impact on therapeutic management and hospital referrals.
Methods: This was an observational, descriptive, and multicenter study conducted in Home-Based Palliative Care Support Teams (ESAPD) in the Community of Madrid. Patients over 18 years of age with advanced cancer receiving home-based care were included, and clinical ultrasound was performed according to professional criteria. Sociodemographic variables, clinical variables (ICD-10, Palliative Performance Scale), type and location of ultrasound scan, findings, therapeutic changes, and hospital referrals were collected. The analysis was descriptive.
Results: 285 ultrasound scans were performed over a six-month period by 15 physicians from 6 Palliative Care Services (ESAPD). The mean age of the patients was 79.2 years (SD: 13.95), 52% were women, and the median Palliative Performance Scale score was 50. The most frequent scans were abdominal (43.5%) and thoracic (22.8%). Pathological findings were identified in 67% of the ultrasound scans. After the ultrasound scan, a change in therapeutic approach occurred in 62% of cases, and hospital referrals were avoided in 70%.
Conclusions: Clinical ultrasound in home-based palliative care is a feasible and useful tool, integrated into clinical practice, that helps reduce diagnostic uncertainty, optimize therapeutic decision-making, and avoid unnecessary hospital transfers, prioritizing patient comfort and quality of life.
DOI: 10.20986/medpal.2026.1653/2026
Health-related quality of life and symptoms of anxiety and depression in ALS: a
cross-sectional study in a reference center in Uruguay
Ana Isabel García-Pérez1, Eric Romero-Atencio2, Sofía Maissonave-Strazzarino3, Jessica Bracco-Thomé1, Viviana Bella-García4, Laura Martínez-Palma5
1UA Psicología Médica, UDA Cuidados Paliativos. Centro de Esclerosis Lateral Amiotrófica del Uruguay (CELAU). Univ. de la República (UDELAR) , Montevideo. 2UA Psicología Médica. CELAU, Hospital de Clínicas, UDELAR, Montevideo. 3UA de Métodos Cuantitativos. UDELAR, Montevideo. 4UDA Cuidados Paliativos. CELAU. Hospital de Clínicas, UDELAR, Montevideo. 5UA de Histología y Embriología. CELAU, UDELAR, Montevideo
Introduction: Amyotrophic lateral sclerosis (ALS) is a multisystem neurodegenerative disease that affects health-related quality of life (HRQoL) and emotional well-being. International evidence has highlighted the impact of non-motor symptoms—particularly anxiety and depression—as significant determinants of HRQoL. In Uruguay, researchers have not yet systematized data on these aspects. Although researchers have widely established the association with depression, they have studied anxiety and other factors less extensively. We aimed to describe HRQoL, determine the frequency of anxiety and depression symptoms, and analyze their relationship in patients with ALS treated at a national reference center. Patients and methods: We conducted a descriptive, correlational, observational, and cross-sectional study with prospective data collection between July 2023 and August 2024, involving 39 patients with a confirmed diagnosis according to the Gold Coast criteria. We assessed HRQoL using the EuroQol-5D (EQ-5D-5L), functionality with the ALSFRS-R, and emotional symptoms with the HADS. Results:We found a median HRQoL of 0.76, lower than that of the general population. We observed a higher frequency of anxiety (56%) than depression (36%), with 33% of patients presenting mixed symptoms. Anxiety was more prevalent in patients with less than 6 months since diagnosis and in those with more than 12 months. HRQoL correlated positively with functionality and negatively with anxiety and depression; anxiety showed an inverse association with HRQoL (rs = −0.44; p < 0.005).Discussion:These findings reinforce the relevance of non-motor symptoms in the ALS experience and highlight the need for early psychological assessment and multidisciplinary interventions. Future studies should investigate the longitudinal progression of these factors throughout the disease course.
DOI: 10.20986/medpal.2026.1648/2025
Integration of Palliative Care in Heart Failure in Colombia: A Cross-Sectional Study.
Leidy Sanchez Bolivar1, María Jennifer Quintero Trejos2, Laura Sequea Torregrosa2, Miguel Antonio Sanchez Cardenas3
1Clinica del Dolor y Cuidados Paliativos. La Cardio- Fundacion Cardioinfantil, Bogota. 2Facultad de Enfermeria. Universidad El Bosque, . 3Bogota. Universidad el Bosque, Bogota
Introduction: The palliative approach to non-oncological diseases is a relevant aspect in achieving the quality of life of patients; etiologies such as heart failure (HF) should receive this management even from the moment of diagnosis. The present work aimed to describe the integration of palliative care (PC) in the care of patients with HF in Colombia during the first half of 2022. Methodology: A descriptive cross-sectional quantitative study was designed that consisted of surveying health professionals immersed in the care of patients with HF classified by territorial nodes. The survey was designed based on indicators that evaluated the integration of PC in HF care in the Colombian context, related to the provision and referral of PC, patient empowerment, family approach, home care, multidisciplinarity, knowledge and holistic care. Results and discussion: It was found, according to the reviewed literature, that PC is almost nonexistent in the early stages of HF. The difficulty in accessing health services in some regions of the country, combined with the lack of training for palliative care professionals, are the main findings of the study. Conclusions: A low level of integration of PCs in HF in Colombia was evident, which calls for strengthening research and care work in this regard.
DOI: 10.20986/medpal.2026.1556/2024
Study of the Efficiency of a National Pioneer Primary Care Pediatric Home Care Program.
Yurena Valencia Afonso1, Dinesh Lalchandani Lalchandani2, Dácil Parrilla Toribio3, Rebeca Afonso Dávila4, José Félix Reyes Rodríguez5, Alfonso Miguel García Hernández6
1Atención Domiciliaria Pediátrica de AP (ADPAP). Gerencia de Atención Primaria de Tenerife, LA LAGUNA. 2Atención Domiciliaria Pediátrica de AP (ADPAP). Gerencia de Atención Primaria de Tenerife, San Cristóbal de la Laguna. 3Medicina intensiva. CHUNSC, San Cristóbal de la Laguna. 4Cuidados paliativos pediátricos. CHUC, . 5Área Técnica de Salud Pública. Gerencia de Atención Primaria de Tenerife, . 6Universidad de La Laguna. Profesor Titular del Grado de Enfermería,
Introduction: In recent decades, scientific and technological advances have contributed to a reduction in pediatric mortality, accompanied by an increase in children surviving severe illnesses with complex sequelae. Many of these situations require Pediatric Palliative Care Units to ensure comprehensive and continuous care. In Spain, approximately 2,500 children die each year and up to 25,000 may require specific pediatric palliative care resources.
Material and methods: Epidemiological, observational, and descriptive cohort study comparing healthcare costs before and after implementation of the ADPAP program, initiated on June 1, 2022. The sample included children enrolled in the program who were also followed by the Pediatric Palliative Care Unit of the Complejo Hospitalario Universitario de Canarias, with healthcare expenditure data available for one year before and one year after implementation.
Results: Of the 70 patients included in the program, 17 had comparable data for both periods. The comparison of total mean costs per patient showed a statistically significant reduction after implementation (t = 3.11; p = 0.0067), with an average saving of €9,170.68 per patient. This represents total savings of €155,901.57 in the analyzed cohort.
Conclusion: The implementation of the ADPAP program proved economically efficient, reducing healthcare costs associated with hospital and primary care services. In a hypothetical extrapolation to a cohort of 70 patients with similar characteristics, annual savings could exceed €600,000, although this estimate should be interpreted cautiously. These findings suggest that coordinated pediatric home care from Primary Care may improve healthcare system efficiency and continuity of care for children with complex chronic conditions, reducing avoidable hospitalizations and optimizing the use of hospital resources.
DOI: 10.20986/medpal.2026.1557/2024
Physical Exercise in Palliative Care (?)
Gonçalo Barata Soares1, Leonor Marques2
1Serviço de Medicina Física e Reabilitação. Instituto Português de Oncologia de Francisco Gentil de Lisboa, Lisboa. 2Unidade de Cuidados Paliativos Clínica São João de Deus, Lisboa
DOI: 10.20986/medpal.2026.1662/2026