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

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

Research output: Contribution to journalArticlepeer-review

Abstract

Background: 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. Methods: Ninety-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). Results: CAM-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. Conclusions: Clinical 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.

Original languageEnglish
Article number162
JournalBMC Palliative Care
Volume19
Issue number1
DOIs
StatePublished - 1 Dec 2020

Keywords

  • Cancer
  • Delirium
  • Exploratory structural equation modelling
  • Latent profile analysis
  • Palliative care

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