Nada Fadul1, Guddi Kaur1, Tao Zhang1, J Lynn Palmer1, Eduardo Bruera2. 1. Department of Palliative Care and Rehabilitation Medicine, The University of Texas M.D. Anderson Cancer Center, Unit 008, 1515 Holcombe Blvd., Houston, TX, 77030, USA. 2. Department of Palliative Care and Rehabilitation Medicine, The University of Texas M.D. Anderson Cancer Center, Unit 008, 1515 Holcombe Blvd., Houston, TX, 77030, USA. ebruera@mdanderson.org.
Abstract
BACKGROUND: Delirium is among the most common neuropsychiatric complications of advanced cancer. The Memorial Delirium Assessment Scale (MDAS) is a widely used and validated screening tool for delirium in cancer patients. OBJECTIVE: The purpose of this study was to assess the use of the MDAS by different palliative care health professionals after receiving formal training and a guiding manual for administration and scoring. MATERIALS AND METHODS: Thirty-one palliative care health professionals received a training session on the MDAS, including description of the tool, validation, and scoring. Participants also received copies of a proposed standardized manual for completion of the MDAS. Two of the investigators presented three simulated cases to the participants, who independently completed a scoring sheet for each case. The data were then analyzed according to the cases and the profession of the operators. RESULTS: Thirty-one scoring sheets were analyzed (11 physicians, 12 nurses, and 8 others). A correct diagnosis was achieved by 30 (96.8%) of the 31 participants in case 1 (nondelirious, true score = 5, median = 5, range = 2-15), 28 of 31 (90.3%) in case 2 (severe mixed delirium, true score = 20, median = 18, range = 10-26), and 31 of 31 in case 3 (mild hypoactive delirium, true score = 14, median = 19, range = 13-25). Overall percentage of error was 31% for items 2, 3, and 4 (cognitive) and 45% for all other items (observational) (p < 0.001). The percentage of error did not differ between physicians and nurses and other palliative care professionals (p > 0.99). CONCLUSIONS: Our preliminary results suggest that adequate training and a guiding manual can enhance the application of MDAS by palliative care health professionals in the teaching settings. Clinical studies to assess the utility of the MDAS as a screening tool are justified to further confirm these findings.
BACKGROUND:Delirium is among the most common neuropsychiatric complications of advanced cancer. The Memorial Delirium Assessment Scale (MDAS) is a widely used and validated screening tool for delirium in cancerpatients. OBJECTIVE: The purpose of this study was to assess the use of the MDAS by different palliative care health professionals after receiving formal training and a guiding manual for administration and scoring. MATERIALS AND METHODS: Thirty-one palliative care health professionals received a training session on the MDAS, including description of the tool, validation, and scoring. Participants also received copies of a proposed standardized manual for completion of the MDAS. Two of the investigators presented three simulated cases to the participants, who independently completed a scoring sheet for each case. The data were then analyzed according to the cases and the profession of the operators. RESULTS: Thirty-one scoring sheets were analyzed (11 physicians, 12 nurses, and 8 others). A correct diagnosis was achieved by 30 (96.8%) of the 31 participants in case 1 (nondelirious, true score = 5, median = 5, range = 2-15), 28 of 31 (90.3%) in case 2 (severe mixed delirium, true score = 20, median = 18, range = 10-26), and 31 of 31 in case 3 (mild hypoactive delirium, true score = 14, median = 19, range = 13-25). Overall percentage of error was 31% for items 2, 3, and 4 (cognitive) and 45% for all other items (observational) (p < 0.001). The percentage of error did not differ between physicians and nurses and other palliative care professionals (p > 0.99). CONCLUSIONS: Our preliminary results suggest that adequate training and a guiding manual can enhance the application of MDAS by palliative care health professionals in the teaching settings. Clinical studies to assess the utility of the MDAS as a screening tool are justified to further confirm these findings.
Authors: M S Albert; S E Levkoff; C Reilly; B Liptzin; D Pilgrim; P D Cleary; D Evans; J W Rowe Journal: J Geriatr Psychiatry Neurol Date: 1992 Jan-Mar Impact factor: 2.680
Authors: Frances M Yang; Edward R Marcantonio; Sharon K Inouye; Dan K Kiely; James L Rudolph; Michael A Fearing; Richard N Jones Journal: Psychosomatics Date: 2009 May-Jun Impact factor: 2.386
Authors: Song Yuin Lee; James Fisher; Anne P F Wand; Koen Milisen; Elke Detroyer; Sanjeev Sockalingam; Meera Agar; Annmarie Hosie; Andrew Teodorczuk Journal: Eur Geriatr Med Date: 2020-01-14 Impact factor: 1.710
Authors: Joseph Arthur; Kimberson Tanco; Ali Haider; Courtney Maligi; Minjeong Park; Diane Liu; Eduardo Bruera Journal: Support Care Cancer Date: 2017-04-06 Impact factor: 3.603
Authors: Ahmed F Elsayem; Eduardo Bruera; Alan Valentine; Carla L Warneke; Geri L Wood; Sai-Ching J Yeung; Valda D Page; Julio Silvestre; Patricia A Brock; Knox H Todd Journal: Oncologist Date: 2017-08-01