Phenomenological examinations of delirium in advanced cancer patients: exploratory structural equation modelling and latent profile analysis

Eun-Jung Shim,Kyung-Lak Son,Moon-Hee Lee,Bong-Jin Hahm,Jisun Park,Won-Hyoung Kim,Chan-Woo Yeom,Kwang-Min Lee,Hyeju Ha

doi:10.1186/s12904-020-00668-0

Abstract

BackgroundThis study examined phenomenological manifestations of delirium in advanced cancer patients by examining the factor structure of the Delirium Rating Scale-Revised-98 (DRS-R-98) and profiles of delirium symptoms.MethodsNinety-three patients with advanced cancer admitted to inpatient palliative care units in South Korea were examined by psychiatrists using the DRS-R-98 and the Confusion Assessment Method (CAM). The factor structure of the DRS-R-98 was examined by exploratory structural equation modelling analysis (ESEM) and profiles of delirium were examined by latent profile analysis (LPA).ResultsCAM-defined delirium was present in 66.6% (n = 62) of patients. Results from the ESEM analysis confirmed applicability of the core and noncore symptom factors of the DRS-R-98 to advanced cancer patients. LPA identified three distinct profiles of delirium characterizing the overall severity of delirium and its core and noncore symptoms. Class 1 (n = 55, 59.1%) showed low levels of all delirium symptoms. Class 2 (n = 17, 18.3%) showed high levels of core symptoms only, whereas Class 3 (n = 21, 22.6%) showed high levels of both core and noncore symptoms except motor retardation.ConclusionsClinical care for delirium in advanced cancer patients may benefit from consideration of the core and noncore symptom factor structure and the three distinct phenomenological profiles of delirium observed in the present study.

Highlights

This study examined phenomenological manifestations of delirium in advanced cancer patients by examining the factor structure of the Delirium Rating Scale-Revised-98 (DRS-R-98) and profiles of delirium symptoms
The present study aimed to examine whether the core and noncore factors proposed by Thurber et al [10] is applicable to advanced cancer patients in an attempt to explore the phenomenology of delirium as observed in advanced cancer patients [15]
Participant characteristics and symptoms of delirium A total of 93 patients with advanced cancer receiving palliative were examined, and their sociodemographic characteristics are shown in supplementary Table 1

Summary

Introduction

This study examined phenomenological manifestations of delirium in advanced cancer patients by examining the factor structure of the Delirium Rating Scale-Revised-98 (DRS-R-98) and profiles of delirium symptoms. Pooled prevalence estimates indicated that one third of patients were diagnosed with delirium at the time of admission to inpatient palliative care [1]. This high prevalence reflects that patients in palliative care settings are more frail, with poor performance status [2]. It was suggested that delirium-induced disinhibition may result in the overexpression and worsening of physical and psychological symptoms [3]. It affects survival length [2], and it distresses the family members of terminal cancer patients [4]

Methods

Results

Discussion

Conclusion