Depressão autorreferida e sintomas graves pelo Edmonton Symptom Assessment System em pacientes internados em enfermarias clínicas

Abstract

Introduction: Healthcare professionals involved in treating patients with various symptoms need to incorporate knowledge and skills to improve care. To facilitate the assessment of symptoms and treatment effects, the use of scales is very important. The Edmonton Symptom Assessment System (ESAS) is used for this purpose. It is important to assess the prevalence of symptoms and their possible associated factors, including self-reported depression. Objectives: To evaluate the prevalence of factors associated with severe ESAS score of 7 points or more in one or more of its domains. Method: We evaluated patients admitted to internal medicine wards for three days or more. Sociodemographic data, clinical data and the ESAS questionnaire were collected. The ESAS has 10 domains, one of which being related to depression. ESAS was used with 10 domains and 9 domains (without depression domain). ESAS was classified as severe (with a score of 7 points or more in at least one domain) and non severe. In the multivariate statistical evaluation, the independent variables associated with severe and severe ESAS without the depression domain were identified. Results: 93 patients were included in the study, of which 40 (43.01%) were females. The mean age was 53.11 ± 18.28 years, religion considered very important by 74 (79.56%), non-white ethnicity was identified in 70 (75.83%) and depression in 16 (17.20%). Severe ESAS was present in 52.69% of the patients. The final multiple logistic regression model showed self-reported depression as the only factor associated with severe ESAS in the 10-domain protocol (p = 0.02; OR = 4.30 (95% CI 1.21-15.24)); and also as the only factor associated with severe ESAS without the depression domain (p = 0.04; OR = 3.41 (95% CI 1.01-11.53)). Conclusions: The prevalence of severe ESAS was high and the only independent associated factor was self-reported depression. It is necessary to incorporate symptom assessment into routine hospital care, especially in those patients with self-reported depression.