title: [Suffering assessment in the advanced dementia].
abstract: BACKGROUND
  At the end stage of life of dementia, medical comorbidities are associated with a high degree of patient suffering. The aim of this study was to assess the relationship between the lack of symptoms of discomfort and the level of patient suffering. The relationship with psychological distress and caregiver burden was also clarified.
  
  
  METHODS
  This study included patients with advanced dementia according to the criteria of the Hospice Enrolment Criteria for End-stage Dementia patients. Patient suffering was assessed with Mini-Suffering State Examination (MSSE). The caregivers were scored by Zarit caregiver burden scale (ZR), and the General Health Questionnaire of Goldberg (GHQ-28). Central tendency and correlation tests were used in the statistical analysis.
  
  
  RESULTS
  The study recorded data from 71 patients. In the comorbidity of medical symptoms associated with advanced dementia, pneumonia (Spearman's rho: -0.29; P=.01), and malnutrition (Spearman's rho: -0.25; P=.03), showed a significant association with the total scale score of MSSE. There were no significant correlations between patient suffering and caregiver psychological distress (r: 0.11; P=.37), or caregiver burden (r: 0.13; P=.32).
  
  
  CONCLUSIONS
  The identification of suffering in patients with advanced dementia is recognised by specific symptoms, such as pneumonia and malnutrition. The caregiver' psychological distress of the caregiver was shown to be unrelated to patient suffering as measured by MSSE.
authors.affiliation: Servicio de Psiquiatría, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, España. gcosta@vhebron.net
authors.forename: Gema
authors.initials: G
authors.lastname: Costa Requena
authors.forename: M Carmen
authors.initials: MC
authors.lastname: Espinosa Val
authors.forename: Ramón
authors.initials: R
authors.lastname: Cristófol Allue
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003704:Dementia / Q000150:complications* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000209:etiology*