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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.

INTRODUCTION: Pediatric palliative care (PPC) focuses on the comprehensive management of incurable diseases or conditions in children, as well as providing support to families from diagnosis through bereavement. This care requires a multidisciplinary approach in which physicians and nurses play an essential role; therefore, it is imperative to acquire these competencies during their formative years. OBJECTIVE: To evaluate the knowledge and attitudes regarding pediatric palliative care among Nursing and Medicine students at a higher education institution in Cartagena (Colombia). MATERIALS AND METHODS: A quantitative, cross-sectional study was conducted, utilizing Chi-square tests for association analysis. From a total population of 496 nursing and medicine students, a simple random probability sample of 192 individuals was selected. Data collection was performed using a sociodemographic survey, the PPC knowledge assessment instrument developed by Garaycochea, and the pediatric palliative care attitude scale designed by Hilario. RESULTS AND DISCUSSION: The students were mainly female (71.9%), 21 - 22 years old (46.9%), urban (83.9%) and single (88%). Knowledge of pediatric palliative care was fair (66.1%), while attitudes were adequate (69.8%). The association between attitudes, knowledge and sociodemographic aspects of the students was confirmed (p<0.05). Nursing and medical students have regular knowledge, but a good attitude towards pediatric palliative care, a situation that should be taken advantage of by Higher Education Institutions for its inclusion in the curricula in order to train integral and competent professionals for the care of this population.

Editorial

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.

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.

Introduction: Red blood cell and platelet transfusion is a treatment used at the end of life for symptomatic relief. However, its benefits, as well as the survival time after transfusion, are debated. This study aims to determine the prevalence, clinical characteristics, whether or not patients received palliative care, and survival of these patients to guide future studies and facilitate decision-making.
Patients and methods: This was a descriptive, cross-sectional study with retrospective data collection. Sociodemographic, clinical, and diagnostic variables, as well as whether patients received palliative care, treatment, and complications, were included. All adult patients with solid organ cancer who received red blood cell and/or platelet transfusions in the last 6 months of life and were treated at a high-complexity hospital between 2019 and 2022 were included. Data were obtained through review and analysis of medical records after authorization from the institutional ethics committee and entered into the BDClinic platform. Univariate and bivariate analyzes were performed for each variable.

Results: A population of 234 patients who met the selection criteria was analyzed. The median age was 61.8 years, and 60% of the population were women. The most common cancer was gastrointestinal (42.74%). Early palliative care intervention was associated with 31.5% of all transfusions and a median survival of 20 days from the last red blood cell transfusion. Patients receiving palliative care exclusively had a median survival after transfusion of 18 days, the longest compared to the other groups.

Conclusions: The appropriateness of therapeutic measures such as transfusions is plausible with early intervention by palliative care, and this is a bioethical imperative that plays a crucial role to consider in the final phase of life.

Introduction: Palliative care enhance the quality of life for those dealing with a terminal illness. However, many people are unable to access this type of care, especially in Latin American countries. Therefore, the aim of this study is to determine the effect of an educational intervention program on palliative care among medical students.
Material and Method: This quasi-experimental study involved sixth-year students from the Faculty of Human Medicine at the Universidad Científica del Sur of any age and gender who wished to participate in the study. A previously translated and adapted questionnaire for undergraduate students in our country, originally from Japan, was used to measure the level of knowledge about palliative care among healthcare professionals. The sample was described using frequency tables for each variable pre- and post-test. Normality of the scores obtained in each section of questions was determined using the Shapiro-Wilk test, and since normal distribution was not found, these results were compared using the Wilcoxon test. Finally, a "score variation" variable was created to determine the association of gender, age, and learning type with this variation.
Results: A total of 37 students were evaluated in the study. The total post-intervention score improved significantly compared to the initial score. No association was found between the score variation (pre- and post-test) and age, gender, or learning style.
Discussion: The educational intervention demonstrated a favorable impact on the initial results. Compared to other studies, the educational intervention increased the participants' mastery of palliative care in all sections of questions, especially in "Palliative Care Symptomatology" and "Pharmacology." The incorporation of academic programs on palliative care in Peruvian universities is suggested.