Phenomenological examinations of delirium in advanced cancer patients: exploratory structural equation modelling and lat
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RESEARCH ARTICLE
Open Access
Phenomenological examinations of delirium in advanced cancer patients: exploratory structural equation modelling and latent profile analysis Eun-Jung Shim1, Hyeju Ha1, Won-Hyoung Kim2, Moon-Hee Lee3, Jisun Park3, Kwang-Min Lee4, Kyung-Lak Son5, Chan-Woo Yeom6 and Bong-Jin Hahm7,8*
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. Keywords: Cancer, Delirium, Exploratory structural equation modelling, Latent profile analysis, Palliative care
* Correspondence: [email protected]; [email protected] 7 Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea 8 Department of Psychiatry and Behavioral Sciences, Seould National University College of Medicine, Seoul, Republic of Korea Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommon
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