“Compassionate City” in Patients with Advanced Illnesses and at the End of Life: A Pilot Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Studio Design
2.2. Study Population
2.3. Intervention Process and Variables
Sociodemographic characterization of people referred and beneficiaries of the program. |
|
Referral to the program. |
|
Inclusion in the program, scope of care and state of the population. |
|
Social assessment of beneficiaries of the program. |
|
Sociodemographic characterization of main caregiver. |
|
Characterization of initial network and final support network (internal, external and community). |
|
Quality of Life and Well-being Impact. |
|
Assessment of Loneliness (ESTE II Scale) [24]. |
|
Quality-of-Life Assessment (EUROQOL-5D) [25]. |
|
Main Caregiver Burden (Reduced Zarit Scale) [26]. |
|
Family satisfaction. |
No, never (1), A few times (2), Sometimes (3), Quite a few times (4), Yes, always (5). |
2.4. Information Sources, Data Collection and Processing
2.5. Statistical Analysis
2.6. Ethical Considerations and Data Protection
3. Results
3.1. Referral to the Program
3.2. Population Included in the Program
3.3. Scope and Status of the Population at the End of the Study
3.4. Social Assessment of Beneficiaries of the Program
3.5. Sociodemographic Characterization of the Primary Caregiver
3.6. Initial Network and Final Support Network
3.7. Impact on Quality of Life and Well-Being
3.8. Assessment of Loneliness (ESTE II Scale)
3.9. Quality of Life (EUROQOL 5D)
3.10. Burden of Primary Caregivers (ZARIT Reduced Scale)
3.11. Satisfaction of the Community Intervention Process
4. Discussion
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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District | District 1. (San Pablo/Santa Justa) | District 2. Macarena | District 3. Nervión | Total | ||||
---|---|---|---|---|---|---|---|---|
Origin | Cancer | Non Cancer | No Data | Cancer | Non Cancer | Cancer | Non Cancer | n (%) |
Primary Care | 27 (32.5%) | 17 (20.5%) | 7 (8.4%) | 3 (15.0%) | 9 (45.0%) | 63 * (60.6%) | ||
PC Team | 6 (7.2%) | 9 (10.8%) | 4 (20.0%) | 1 (5.0%) | 21 (19.2%) | |||
Social services | 3 (3.6%) | 11 (13.3%) | 1 (1.2%) | 1 (5.0%) | 16 ** (15.4%) | |||
Key agents | 1 (1.2%) | 0 (0.0%) | 1 (100%) | 0 (0.0%) | 2 (1.9%) | |||
Community network | 1 (1.2%) | 0 (0.0%) | 1 (5.0%) | 0 (0.0%) | 2 (1.9%) | |||
Family | 1 (5.0%) | 0 (0.0%) | 1 (1.0%) | |||||
Total diagnosis Oncology = 49 Non-cancer = 47 No specification = 8 | 38 (45.8%) | 37 (44.6%) | 8 (9.6%) | 10 (50%) | 10 (50%) | 1 (100%) | 0 (0.0%) | |
Total derivation Men = 56 (53.8%) Women = 48 (46.2% Age = 74.3 years | 83 (79.8%) | 20 (19.2%) | 1 (1%) | 104 (100%) |
Initial Network | Final Network | Initial Network | Final Network | |||
---|---|---|---|---|---|---|
Total (%) | Involve (%) | Involve (%) | People | Involved | Involved | |
Family | ||||||
Internal network | 306 (72.9%) | 217 (76.1%) | 295 (60.6%) | 3.9 | 2.7 | 3.6 |
Non-family | ||||||
External network | 74 (17.6%) | 44 (15.4%) | 117 (24.0%) | 0.9 | 0.5 | 1.4 |
Community | 40 (9.5%) | 24 (8.4%) | 75 (15.4%) | 0.5 | 0.3 | 0.9 |
Total | 420 | 285 | 487 | 5.4 | 3.6 | 6.1 |
Type of Need | People without Need (%) | People in Need | ||
---|---|---|---|---|
Satisfied (%) | Not Satisfied (%) | Total Peolple in Need * (%) | ||
Barthel | ||||
To get ready | 26 (32.1%) | 55 (67.9%) | 0 (0.0%) | 55 (67.9%) |
Bath (Wash) | 22 (27.2%) | 57 (70.4%) | 2 (2.5%) | 59 (72.8%) |
To eat | 32 (39.5%) | 47 (58.0%) | 2 (2.5%) | 49 (60.5%) |
Wandering | 42 (51.9%) | 34 (42.0%) | 5 (6.2%) | 39 (48.1%) |
Deposition | 49 (60.5%) | 30 (37.0%) | 2 (2.5%) | 32 (39.5%) |
Go to the toilet. Unable to access or use | 54 (66.7%) | 26 (32.1%) | 1 (1.2%) | 27 (33.3%) |
Urination | 50 (61.7%) | 30 (37.0%) | 1 (1.2%) | 31 (38.3%) |
Go up/down stairs | 55 (67.9%) | 19 (23.5%) | 7 (8.6%) | 26 (32.1%) |
Transfer (bed/chair). Two people | 40 (49.4%) | 38 (46.9%) | 3 (3.7%) | 41 (50.6%) |
Dress | 25 (30.9%) | 56 (69.1%) | 0 (0.0%) | 56 (69.1%) |
Lawton and Brody | ||||
Home care | 8 (9.9%) | 72 (88.9%) | 1 (1.2%) | 73 (90.1%) |
Go shopping | 10 (12.3%) | 70 (86.4%) | 1 (1.2%) | 71 (87.7%) |
Laundry | 11 (13.6%) | 69 (85.2%) | 1 (1.2%) | 70 (86.4%) |
Money handling | 30 (37.0%) | 49 (60.5%) | 2 (2.5%) | 51 (63.0%) |
Food preparation | 35 (43.2%) | 43 (53.1%) | 3 (3.7%) | 46 (56.8%) |
Responsibility for your medication | 24 (29.6%) | 55 (67.9%) | 2 (2.5%) | 57 (70.4%) |
Use of means of transport | 45 (55.6%) | 32 (39.5%) | 4 (4.9%) | 36 (44.4%) |
Phone use | 47 (58.0%) | 30 (37.0%) | 4 (4.9%) | 34 (42.0%) |
Others (emotional, accompaniment) | ||||
Accompanied on medical visits | 18 (22.2%) | 60 (74.1%) | 3 (3.7%) | 63 (77.8%) |
Accompanies the patient at home, hospital | 4 (4.9%) | 74 (91.4%) | 3 (3.7%) | 77 (95.1%) |
Entertainment | 33 (40.7%) | 35 (43.2%) | 13 (16.0%) | 48 (59.3%) |
Facilitates emotional release | 28 (34.6%) | 38 (46.9%) | 15 (18.5%) | 53 (65.4%) |
Information management/communication with professionals, family | 19 (23.5%) | 62 (76.5%) | 0 (0.0%) | 62 (76.5%) |
Manage visits, calls for consultation, emergencies | 12 (14.8%) | 69 (85.2%) | 0 (0.0%) | 69 (85.2%) |
Wills | 44 (54.3%) | 4 (4.9%) | 33 (40.7%) | 37 (45.7%) |
Type of Need | People without Need (%) | People in Need | ||
---|---|---|---|---|
Satisfied (%) | Not Satisfied (%) | Total Peolple in Need * (%) | ||
Barthel | ||||
To get ready | 14 (22.6%) | 48 (77.4%) | 0 (0.0%) | 48 (77.4%) |
Bath (Wash) | 12 (19.4%) | 49 (79.0%) | 1 (1.6%) | 50 (80.6%) |
To eat | 24 (38.7%) | 37 (59.7%) | 1 (1.6%) | 38 (61.3%) |
Wandering | 34 (54.8%) | 24 (38.7%) | 4 (6.5%) | 28 (45.2%) |
Deposition | 35 (56.5%) | 26 (41.9%) | 1 (1.6%) | 27 (43.5%) |
Go to the toilet. Unable to access or use | 38 (61.3%) | 24 (38.7%) | 0 (0.0%) | 24 (38.7%) |
Urination | 37 (59.7%) | 24 (38.7%) | 1 (1.6%) | 25 (40.3%) |
Go up/down stairs | 47 (75.8%) | 10 (16.1%) | 5 (8.1%) | 15 (24.2%) |
Transfer (bed/chair). Two people | 31 (50.0%) | 28 (45.2%) | 3 (4.8%) | 31 (50.0%) |
Dress | 11 (17.7%) | 51 (82.3%) | 0 (0.0%) | 51 (82.3%) |
Lawton and Brody | ||||
Home care | 8 (12.9%) | 53 (85.5%) | 1 (1.6%) | 54 (87.1%) |
Go shopping | 8 (12.9%) | 54 (87.1%) | 0 (0.0%) | 54 (87.1%) |
Laundry | 7 (11.3%) | 54 (87.1%) | 1 (1.6%) | 55 (88.7%) |
Money management (Financial matters) | 18 (29.0%) | 42 (67.7%) | 2 (3.2%) | 44 (71.0%) |
Food preparation | 22 (35.5%) | 39 (62.9%) | 1 (1.6%) | 40 (64.5%) |
Responsibility for your medication | 18 (29.0%) | 43 (69.4%) | 1 (1.6%) | 44 (71.0%) |
Use of means of transport | 41 (66.1%) | 18 (29.0%) | 3 (4.8%) | 21 (33.9%) |
Phone use | 31 (50.0%) | 27 (43.5%) | 4 (6.5%) | 31 (50.0%) |
Others (emotional, accompaniment) | ||||
Accompanied on medical visits | 14 (22.6%) | 47 (75.8%) | 1 (1.6%) | 48 (77.4%) |
Accompanies the patient at home, hospital | 4 (6.5%) | 58 (93.5%) | 0 (0.0%) | 58 (93.5%) |
Entertainment | 13 (21.0%) | 45 (72.6%) | 4 (6.5%) | 49 (79.0%) |
Facilitates emotional release | 11 (17.7%) | 47 (75.8%) | 4 (6.5%) | 51 (82.3%) |
Information management/communication with professionals, family | 10 (16.1%) | 52 (83.9%) | 0 (0.0%) | 52 (83.9%) |
Manage visits, calls for consultation, emergencies | 7 (11.3%) | 55 (88.7%) | 0 (0.0%) | 55 (88.7%) |
Wills | 28 (45.1%) | 1 (1.6%) | 33 (53.2%) | 34 (54.8%) |
Loneliness | Initial Network n = 57 | Final Network n = 24 | ||
---|---|---|---|---|
Average Punctuation | Number of People (%) | Average Punctuation | Number of People (%) | |
Short | 8.1 | 18 (31.6%) | 8 | 9 (37.5%) |
Half | 14.7 | 37 (64.9%) | 14.1 | 14 (58.3%) |
high | 22 | 2 (3.5%) | 21 | 1 (4.2%) |
Total | 57 (100%) | 24 (100%) |
Mobility | I have no problem walking | I have some trouble walking. | I have to be in bed |
Initial assessment | 4 (15.4%) | 17 (65.4%) | 5 (19.2%) |
Final assessment | 4 (15.4%) | 14 (53.8%) | 8 (30.8%) |
Personal care | I have no problems with Personal Care. | I have some trouble washing or dressing myself. | I am unable to wash or dress myself. |
Initial assessment | 2 (7.7%) | 13 (50.0%) | 11 (42.3%) |
Final assessment | 3 (11.5%) | 11 (42.3%) | 12 (46.2%) |
Daily activities | I have no problems doing my daily activities. | I have some problems doing my daily activities. | Yes, I am unable to carry out my daily activities. |
Initial assessment | 2 (7.7%) | 13 (50.0%) | 11 (42.3%) |
Final assessment | 2 (7.7%) | 10 (38.5%) | 14 (53.8%) |
Pain/Discomfort | I have no pain or discomfort. | I have moderate pain or discomfort. | I have a lot of pain or discomfort. |
Initial assessment | 16 (61.5%) | 6 (23.1%) | 4 (15.4%) |
Final assessment | 18 (69.2%) | 7 (26.9%) | 1 (3.8%) |
Anxiety Depression | I am not anxious or depressed. | I am moderately anxious or depressed. | I am very anxious or depressed. |
Initial assessment | 12 (46.2%) | 11 (42.3%) | 3 (11.5%) |
Final assessment | 15 (57.7%) | 10 (38.5%) | 1 (3.8%) |
Thermometer assessment (0 the worst imaginable state of health–100 the best imaginable state of health) | |||
Initial assessment | 42.39 | ||
Final assessment | 45.29 | ||
Score Quality of Life Scale 0 worst quality of life–1 best quality of life | |||
Initial assessment | 0.34 | ||
Final assessment | 0.36 |
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Share and Cite
Librada-Flores, S.; Pérez-Solano Vázquez, M.J.; Lucas-Díaz, M.Á.; Rodríguez Álvarez-Ossorio, Z.; Herrera-Molina, E.; Nabal-Vicuña, M.; Guerra-Martín, M.D. “Compassionate City” in Patients with Advanced Illnesses and at the End of Life: A Pilot Study. Int. J. Environ. Res. Public Health 2023, 20, 2234. https://doi.org/10.3390/ijerph20032234
Librada-Flores S, Pérez-Solano Vázquez MJ, Lucas-Díaz MÁ, Rodríguez Álvarez-Ossorio Z, Herrera-Molina E, Nabal-Vicuña M, Guerra-Martín MD. “Compassionate City” in Patients with Advanced Illnesses and at the End of Life: A Pilot Study. International Journal of Environmental Research and Public Health. 2023; 20(3):2234. https://doi.org/10.3390/ijerph20032234
Chicago/Turabian StyleLibrada-Flores, Silvia, María Jesús Pérez-Solano Vázquez, Miguel Ángel Lucas-Díaz, Zacarías Rodríguez Álvarez-Ossorio, Emilio Herrera-Molina, María Nabal-Vicuña, and María Dolores Guerra-Martín. 2023. "“Compassionate City” in Patients with Advanced Illnesses and at the End of Life: A Pilot Study" International Journal of Environmental Research and Public Health 20, no. 3: 2234. https://doi.org/10.3390/ijerph20032234