Need for Additional Professional Psychosocial and Spiritual Support in Patients with Advanced Diseases in the Course of Specialist Palliative Care - a Longitudinal Observational Study

Overview

Journal BMC Palliat Care

Publisher Biomed Central

Specialty Critical Care

Date 2021 Nov 26

PMID 34823535

Citations 4

Authors

Anneke Ullrich

Holger Schulz

Sven Goldbach

Wiebke Hollburg

Annette Rommel

Marten Muller

Denise Kirsch

Katrin Kopplin-Fortsch

Julia Messerer

Louise Konig

Frank Schulz-Kindermann

Carsten Bokemeyer

Karin Oechsle

Affiliations

Soon will be listed here.

Abstract

Background: We investigated the need for additional professional support and associated factors in patients (pts) at initiation and in the course of in- and outpatient specialist palliative care (I-SPC/O-SPC).

Methods: Pts entering an urban SPC network consecutively completed questionnaires on psychosocial/spiritual problems and support needs within 72 h (T0) as well as within the first 6 weeks (T1) of SPC. Hierarchical linear regression analysis was used to investigate the impact of sociodemographic / disease-related variables, psychological / physical burden, social support, and SPC setting on the extent of support needs.

Results: Four hundred twenty-five pts (70 years, 48% female, 91% cancer, 67% O-SPC) answered at T0, and 167 at T1. At T0, main problems related to transportation, usual activities, and dependency (83-89%). At T1, most prevalent problems also related to transportation and usual activities and additionally to light housework (82-86%). At T0, support needs were highest for transportation, light housework, and usual activities (35-41%). Cross-sectional comparisons of SPC settings revealed higher problem scores in O-SPC compared to I-SPC at T0 (p = .039), but not at T1. Support need scores were higher in O-SPC at T0 (p < .001), but lower at T1 (p = .039). Longitudinal analyses showed a decrease of support need scores over time, independent from the SPC setting. At T0, higher distress (p = .047), anxiety/depression (p < .001), physical symptom burden (p < .001) and I-SPC (p < .001) were associated with higher support need scores (at T1: only higher distress, p = .037).

Conclusion: Need for additional professional psychosocial/spiritual support was identified in up to 40% of pts. with higher need at the beginning of O-SPC than of I-SPC. During SPC, this need decreased in both settings, but got lower in O-SPC than in I-SPC over time. Support need scores were not only associated with psychological, but also physical burden.

Citing Articles

The impact of spiritual care delivered by nurses on patients' comfort: A propensity score matched cohort utilizing electronic health record data.

Dos Santos F, Macieira T, Yao Y, Ardelt M, Keenan G Int J Med Inform. 2024; 183:105319.

PMID: 38163394 PMC: 11165318. DOI: 10.1016/j.ijmedinf.2023.105319.

Specialist palliative care until the very end of life - reports of family caregivers and the multiprofessional team.

Ullrich A, Goldbach S, Hollburg W, Wagener B, Rommel A, Muller M BMC Palliat Care. 2023; 22(1):153.

PMID: 37814271 PMC: 10563273. DOI: 10.1186/s12904-023-01266-6.

"My life became more meaningful": confronting one's own end of life and its effects on well-being-a qualitative study.

Kukla H, Herrler A, Strupp J, Voltz R BMC Palliat Care. 2022; 21(1):58.

PMID: 35484588 PMC: 9050349. DOI: 10.1186/s12904-022-00950-3.

What are the personal last wishes of people with a life-limiting illness? Findings from a longitudinal observational study in specialist palliative care.

Ullrich A, Hollburg W, Schulz H, Goldbach S, Rommel A, Muller M BMC Palliat Care. 2022; 21(1):38.

PMID: 35317813 PMC: 8939163. DOI: 10.1186/s12904-022-00928-1.

References

Rha S, Lee H, Lee J . Unmet needs in the physical and daily living domain mediates the influence of symptom experience on the quality of life of gastric cancer patients. Support Care Cancer. 2019; 28(3):1419-1431. DOI: 10.1007/s00520-019-04954-3. View

Kroenke K, Spitzer R, Williams J, Lowe B . An ultra-brief screening scale for anxiety and depression: the PHQ-4. Psychosomatics. 2009; 50(6):613-21. DOI: 10.1176/appi.psy.50.6.613. View

Gotze H, Brahler E, Gansera L, Polze N, Kohler N . Psychological distress and quality of life of palliative cancer patients and their caring relatives during home care. Support Care Cancer. 2014; 22(10):2775-82. DOI: 10.1007/s00520-014-2257-5. View

Osse B, Vernooij-Dassen M, Schade E, Grol R . A practical instrument to explore patients' needs in palliative care: the Problems and Needs in Palliative Care questionnaire short version. Palliat Med. 2007; 21(5):391-9. DOI: 10.1177/0269216307078300. View

Stegmann M, Geerse O, Tange D, Richel C, Brom L, Engelen V . Experiences and needs of patients with incurable cancer regarding advance care planning: results from a national cross-sectional survey. Support Care Cancer. 2020; 28(9):4211-4217. DOI: 10.1007/s00520-019-05285-z. View

Higginson I, Hart S, Koffman J, Selman L, Harding R . Needs assessments in palliative care: an appraisal of definitions and approaches used. J Pain Symptom Manage. 2007; 33(5):500-5. DOI: 10.1016/j.jpainsymman.2007.02.007. View

Moghaddam N, Coxon H, Nabarro S, Hardy B, Cox K . Unmet care needs in people living with advanced cancer: a systematic review. Support Care Cancer. 2016; 24(8):3609-22. DOI: 10.1007/s00520-016-3221-3. View

Wang T, Molassiotis A, Chung B, Tan J . Unmet care needs of advanced cancer patients and their informal caregivers: a systematic review. BMC Palliat Care. 2018; 17(1):96. PMC: 6057056. DOI: 10.1186/s12904-018-0346-9. View

Hess S, Stiel S, Hofmann S, Klein C, Lindena G, Ostgathe C . Trends in specialized palliative care for non-cancer patients in Germany--data from the national hospice and palliative care evaluation (HOPE). Eur J Intern Med. 2014; 25(2):187-92. DOI: 10.1016/j.ejim.2013.11.012. View

10.

OCallaghan C, Georgousopoulou E, Seah D, Clayton J, Kissane D, Michael N . Spirituality and religiosity in a palliative medicine population: mixed-methods study. BMJ Support Palliat Care. 2020; 12(3):316-323. DOI: 10.1136/bmjspcare-2020-002261. View

11.

Janda M, Steginga S, Dunn J, Langbecker D, Walker D, Eakin E . Unmet supportive care needs and interest in services among patients with a brain tumour and their carers. Patient Educ Couns. 2008; 71(2):251-8. DOI: 10.1016/j.pec.2008.01.020. View

12.

Roth A, Kornblith A, Batel-Copel L, Peabody E, Scher H, Holland J . Rapid screening for psychologic distress in men with prostate carcinoma: a pilot study. Cancer. 1998; 82(10):1904-8. DOI: 10.1002/(sici)1097-0142(19980515)82:10<1904::aid-cncr13>3.0.co;2-x. View

13.

Hong J, Song Y, Liu J, Wang W, Wang W . Perception and fulfillment of cancer patients' nursing professional social support needs: from the health care personnel point of view. Support Care Cancer. 2013; 22(4):1049-58. DOI: 10.1007/s00520-013-2062-6. View

14.

Funk-Lawler R, Mundey K . Understanding Distress Among Patients With Cancer Receiving Specialized, Supportive Care Services. Am J Hosp Palliat Care. 2020; 37(10):830-836. DOI: 10.1177/1049909120905780. View

15.

Chua G, Pang G, Yee A, Neo P, Zhou S, Lim C . Supporting the patients with advanced cancer and their family caregivers: what are their palliative care needs?. BMC Cancer. 2020; 20(1):768. PMC: 7429720. DOI: 10.1186/s12885-020-07239-9. View

16.

Seekatz B, Lukasczik M, Lohr M, Ehrmann K, Schuler M, Kessler A . Screening for symptom burden and supportive needs of patients with glioblastoma and brain metastases and their caregivers in relation to their use of specialized palliative care. Support Care Cancer. 2017; 25(9):2761-2770. DOI: 10.1007/s00520-017-3687-7. View

17.

Walling A, Tisnado D, Ettner S, Asch S, Dy S, Pantoja P . Palliative Care Specialist Consultation Is Associated With Supportive Care Quality in Advanced Cancer. J Pain Symptom Manage. 2016; 52(4):507-514. PMC: 5173291. DOI: 10.1016/j.jpainsymman.2016.04.005. View

18.

Teo I, Krishnan A, Lee G . Psychosocial interventions for advanced cancer patients: A systematic review. Psychooncology. 2019; 28(7):1394-1407. DOI: 10.1002/pon.5103. View

19.

Kuon J, Vogt J, Mehnert A, Alt-Epping B, van Oorschot B, Sistermanns J . Symptoms and Needs of Patients with Advanced Lung Cancer: Early Prevalence Assessment. Oncol Res Treat. 2019; 42(12):650-659. DOI: 10.1159/000502751. View

20.

Boyes A, Clinton-McHarg T, Waller A, Steele A, DEste C, Sanson-Fisher R . Prevalence and correlates of the unmet supportive care needs of individuals diagnosed with a haematological malignancy. Acta Oncol. 2014; 54(4):507-14. DOI: 10.3109/0284186X.2014.958527. View