Depression in patients with advanced illness: An examination of Ontario complex continuing care using the Minimum Data Set 2.0

Gruneir, Andrea; Smith, Trevor F.; Hirdes, John P.; Cameron, Roy

doi:10.1017/s1478951505050170

Cited by 21 publications

(16 citation statements)

References 42 publications

(27 reference statements)

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“…[13][14][15][16] Cognitive functioning was assessed according to an item indicating acute mental status change and the Cognitive Function Scale (CFS). 17 The CFS combines staff perceptions of resident cognition with the results of a 3-task cognitive screener used to classify residents as cognitively intact (1), mildly impaired (2), moderately impaired (3), or severely impaired (4). Cognitive impairment sequelae were also measured using the Aggressive Behavior Scale (ABS) and a measure of impairment in daily cognitive function.…”

Section: Methodsmentioning

confidence: 99%

“…Physical functioning is measured according to a dependency summary score for ADLs. 19 For each of seven ADLs, residents are rated as independent (0), requiring supervision (1), requiring limited assistance (2), requiring extensive assistance (3), or being totally dependent (4). Severe functional impairment is defined as having a summary score of 21 or higher, meaning that the resident requires at least extensive assistance on all 7 named tasks.…”

Section: Methodsmentioning

confidence: 99%

“…The Changes in Health, End‐stage disease and Symptoms and Signs (CHESS) scale is a composite measure specifically designed to identify health instability in long‐term care populations using routinely collected data . Since its development in 2003, it has been used, primarily as a risk adjustment tool, to identify people with high health instability who are likely to experience adverse health outcomes, including death …”

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confidence: 99%

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Minimum Data Set Changes in Health, End‐Stage Disease and Symptoms and Signs Scale: A Revised Measure to Predict Mortality in Nursing Home Residents

Ogarek

McCreedy

Thomas

et al. 2018

J American Geriatrics Society

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OBJECTIVES To revise the Minimum Data Set (MDS) Changes in Health, End-stage disease and Symptoms and Signs (CHESS) scale, an MDS 2.0-based measure widely used to predict mortality in institutional settings, in response to the release of MDS 3.0. DESIGN Development of a predictive scale using observational data from the MDS and Medicare Master Beneficiary Summary File. SETTING All Centers for Medicare and Medicaid Services (CMS)-certified nursing homes in the United States. PARTICIPANTS Development cohort of 1.3 million Medicare beneficiaries newly admitted to a CMS-certified nursing home during 2012. Primary validation cohort of 1.2 million Medicare recipients who were newly admitted to a CMS-certified nursing home during 2013. MEASUREMENTS Items from the MDS 3.0 assessments identified as likely to predict mortality. Death information was obtained from the Medicare Master Beneficiary Summary File. RESULTS MDS-CHESS 3.0 scores ranges from 0 (most stable) to 5 (least stable). Ninety-two percent of the primary validation sample with a CHESS scale score of 5 and 15% with a CHESS scale of 0 died within 1 year. The risk of dying was 1.63 times as great (95% CI=1.628–1.638) for each unit increase in CHESS scale score. The MDS-CHESS 3.0 is also strongly related to hospitalization within 30 days and successful discharge to the community. The scale predicted death in long-stay residents at 30 days (C=0.759, 95% confidence interval (CI)=0.756–0.761), 60 days (C=0.716, 95% CI=0.714–0.718) and 1 year (C=0.655, 95% CI=0.654–0.657). CONCLUSION The MDS-CHESS 3.0 predicts mortality in newly admitted and long-stay nursing home populations. The additional relationship to hospitalizations and successful discharges to community increases the utility of this scale as a potential risk adjustment tool.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Minimum Data Set Changes in Health, End‐Stage Disease and Symptoms and Signs Scale: A Revised Measure to Predict Mortality in Nursing Home Residents

Ogarek

McCreedy

Thomas

et al. 2018

J American Geriatrics Society

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“…Yet a person can appear to have capacity when their decision making is distorted by fear, depression (undiagnosed in 20-30% of terminally ill patients), 16 or simply misinformation. Coercion in decision making may be real or perceived -and the effect of bad care on a person's sense of dignity and personal worth cannot be underestimated.…”

Section: Safeguarding Patients Who Ask For Deathmentioning

confidence: 99%

Crossing the ‘bright line' – difficult decisions at the end of life

Finlay

2006

Clinical Medicine

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-Patients tell us stories about their lives, their symptoms and their interpretation of them. As physicians we try to make sense of the stories, piecing together the fragments that come our way to discern a diagnosis which we then confirm or refute by examination and investigation. Thus was Samuel Gee's life as a physician: with little in the way of diagnostic tools his 'clinical skills' had to be honed finely and his diagnostic nose well attuned. Perhaps we have today lost some of that clinical intuition. We seek the evidence base for all we do, failing to observe subtleties in our quest for hard science. Following Gee's esteemed lead -for he was celebrated for his clinical descriptions -I will unashamedly use doctor-patient experiences to illustrate my points, particularly around end-of-life decisions.

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“…Emotional distress in cancer patients is understandable with commonly expected responses to include fear, sadness, and grief . However, some patients develop more clinically significant conditions such as anxiety, depression, and adjustment disorders with an estimated 35% to 50% of cancer patients meeting criteria for psychological disorders . In addition, psychological and existential distress likely increases as illness progresses and at the end of life .…”

Section: Introductionmentioning

confidence: 99%

Enhancing palliative care patient access to psychological counseling through outreach telehealth services

et al. 2019

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Context: Palliative care encompasses an interdisciplinary team, including mental health care professionals, to address psychological distress of cancer patients. Objectives:To present the implementation of an outreach counseling program via videoconferencing or telephone to patients receiving care in an outpatient palliative care clinic and to compare patients using this service to those who only received psychological counseling in our outpatient clinic. Methods:We conducted a retrospective chart review of cancer patients seen for psychology counseling services in an outpatient supportive care center between June 2015 and March 2017. Results:We reviewed 2072 unique patients (52% of the total patients seen at the outpatient Supportive Care Center), who had 4567 total counseling encounters across outreach and outpatient settings. A total of 452 (22%) patients participated in a combination of outpatient and outreach counseling services. Patients who participated in outreach services had significantly more encounters (311 [69%] had two to five sessions) compared with those who had outpatient services only (1137 [70%] had one session only) (P < .001). Outreach patients also had shorter times between the initial and follow-up encounters (median 14 days) compared with those who had outpatient services only (median 30 days) (P < .0001). Conclusions:Outreach telehealth counseling services was found to enhance palliative care patient access to psychological counseling. These services represent an additional modality for providing continuous psychological care. KEYWORDS cancer, counseling, oncology, outpatient palliative care, palliative care medicine, palliative care psychology, psychological distress in palliative care, psycho-oncology, supportive care, telemental health

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Depression in patients with advanced illness: An examination of Ontario complex continuing care using the Minimum Data Set 2.0

Cited by 21 publications

References 42 publications

Minimum Data Set Changes in Health, End‐Stage Disease and Symptoms and Signs Scale: A Revised Measure to Predict Mortality in Nursing Home Residents

Minimum Data Set Changes in Health, End‐Stage Disease and Symptoms and Signs Scale: A Revised Measure to Predict Mortality in Nursing Home Residents

Crossing the ‘bright line' – difficult decisions at the end of life

Enhancing palliative care patient access to psychological counseling through outreach telehealth services

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