1.The Effectiveness of Palliative Care Interventions for Patients with Amyotrophic Lateral Sclerosis Evaluated Using the Japanese Version of Integrated Palliative Care Outcome Scale (IPOS)
Chihiro MURANO ; Keita TAGAMI ; Kohei KAMIYA ; Shingo KOYAMA ; Akira INOUE ; Tatsushi YAMAKAWA
Palliative Care Research 2025;20(2):103-109
Objective: The effectiveness of palliative care for patients with amyotrophic lateral sclerosis (ALS) has not been fully validated. This study aimed to evaluate the impact of palliative care interventions on ALS patients using the Integrated Palliative care Outcome Scale (IPOS). Methods: A retrospective study was conducted on ALS patients at National Hospital Organization Yamagata National Hospital who received interventions from the palliative care team between November 2020 and December 2022 and were proxy-evaluated using IPOS. Results: Eleven patients were included in the analysis. Before and after the palliative care team intervention, the total IPOS score improved significantly from 24 to 18.9 (p=0.032), and the score for “Have you felt at peace” improved from 2 to 1 (p=0.031). Conclusion: Palliative care interventions may help alleviate suffering in ALS patients. However, further studies with larger sample sizes and long-term observational research are required to confirm these findings.
2.Influence of Activities of Daily Living on Discharge Destination of Hospitalized Older Patients
Takuma KOMATSU ; Shingo KOYAMA ; Hironobu KATATA ; Shotaro SASAKI ; Yasuyuki HATANAKA ; Takuma MOGAMIYA ; Takahiro SHIKENBARU ; Yoshitsugu OMORI ; Masato YAMATOKU ; Nobuyuki SASAKI
The Japanese Journal of Rehabilitation Medicine 2022;59(2):209-216
Objective:We analyzed whether activities of daily living (ADL) had an additive effect on the discharge destination of hospitalized older patients with internal medicine.Methods:Of the 691 patients hospitalized for medical illness aged 65 years or older who received physical therapy during this study period, 186 patients were included in the analysis. The main outcome was the discharge destination. Participants were categorized in the home discharge group and other institution group. The Barthel Index (BI) was used to assess the ADL at the first physical therapy session. Multivariate logistic regression analysis was used to estimate the influence of the BI on determining the discharge destination. The cut-off point of the BI score was evaluated using a receiver operating characteristic curve.Results:During the follow-up period, 17 participants (9.1%) could not be discharged to their homes. Logistic regression analysis showed that the BI influenced discharge destinations (odds ratio:1.54;95% confidence intervals:1.23-1.89). The cut-off point of the BI score for determining home discharge was 72.5 (sensitivity, 0.80;specificity, 0.94;area under the curve, 0.94;positive predictive value:0.99, negative predictive value:0.32).Conclusions:These findings suggest that the BI is a useful predictor for determining the potential destination of hospitalized older patients following discharge. However, the results of this study have limitations such as a low negative predictive value and a limited number of subjects.
3.Influence of Activities of Daily Living on Discharge Destination of Hospitalized Older Patients
Takuma KOMATSU ; Shingo KOYAMA ; Hironobu KATATA ; Shotaro SASAKI ; Yasuyuki HATANAKA ; Takuma MOGAMIYA ; Takahiro SHIKENBARU ; Yoshitsugu OMORI ; Masato YAMATOKU ; Nobuyuki SASAKI
The Japanese Journal of Rehabilitation Medicine 2022;():20040-
Objective:We analyzed whether activities of daily living (ADL) had an additive effect on the discharge destination of hospitalized older patients with internal medicine.Methods:Of the 691 patients hospitalized for medical illness aged 65 years or older who received physical therapy during this study period, 186 patients were included in the analysis. The main outcome was the discharge destination. Participants were categorized in the home discharge group and other institution group. The Barthel Index (BI) was used to assess the ADL at the first physical therapy session. Multivariate logistic regression analysis was used to estimate the influence of the BI on determining the discharge destination. The cut-off point of the BI score was evaluated using a receiver operating characteristic curve.Results:During the follow-up period, 17 participants (9.1%) could not be discharged to their homes. Logistic regression analysis showed that the BI influenced discharge destinations (odds ratio:1.54;95% confidence intervals:1.23-1.89). The cut-off point of the BI score for determining home discharge was 72.5 (sensitivity, 0.80;specificity, 0.94;area under the curve, 0.94;positive predictive value:0.99, negative predictive value:0.32).Conclusions:These findings suggest that the BI is a useful predictor for determining the potential destination of hospitalized older patients following discharge. However, the results of this study have limitations such as a low negative predictive value and a limited number of subjects.