Patients in the Palliative Care Unit: Clarifying Treatment Desires and Analyzing the Relationship between Mobility and Prognostic Score

Abstract

The purpose of this study was twofold: first, we aimed to clarify the kinds of desires expressed by patients admitted to the palliative care unit (PCU). Second, we investigated the relationship between the patient’s mobility, which is the length of time the patient can move, sit, stand, or walk rather than lie flat in bed, and his/her Palliative Prognostic Index (PPI) score in order to predict how long patients could tolerate mobilization and at what point patients could begin practicing mobilization in a rehabilitation setting. The subjects of the study were 76 palliative care patients. Half expressed a desire to go for an outing or visit their home, of which 70% successfully achieved. To investigate mobility, we collected a total of 480 weeks’ worth of patient PPI scores and mobility and analyzed the correlation between them. The analysis showed a negative correlation coefficient of −0.62 between PPI score and patient mobility. In addition, when estimating the cutoff value for mobility using the Receiver Operating Characteristic (ROC) curve, we found that a patient with a PPI score of less than 3.5 could aim for over 60 minutes of mobilization, while a patient with a PPI score of less than 4.5 could aim for 30 minutes or more. Those with a PPI score 5.5 or less were still able to mobilize slightly, but when the score exceeded 6.0, patients experienced difficulty with mobility for even short periods of time.