Need for additional professional psychosocial and spiritual support in patients with advanced diseases in the course of specialist palliative care – a longitudinal observational study

BMC Palliative Care

Frank Schulz-Kindermann¹  Holger Schulz¹  Anneke Ullrich²  Carsten Bokemeyer²  Louise König²  Julia Messerer²  Karin Oechsle²  Katrin Kopplin-Förtsch³  Marten Müller⁴  Annette Rommel⁵  Denise Kirsch⁶  Sven Goldbach⁷  Wiebke Hollburg⁷ 

[1]Department of Medical Psychology, University Medical Center Eppendorf, Hamburg, Germany

[2]Palliative Care Unit, Department of Oncology, Hematology and BMT, University Medical Center Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany

[3]Palliative Care Ward, Agaplesion Diakonie-Hospital, Hamburg, Germany

[4]Palliative Care Ward, Asklepios Hospital Rissen, Hamburg, Germany

[5]Specialist Outpatient Palliative Care Team “Das Palliativteam”, Hamburg, Germany

[6]Specialist Outpatient Palliative Care Team “PCT Hamburg-West”, Hamburg, Germany

[7]Specialist Outpatient Palliative Care Team “PalliativPartner Hamburg GbR”, Hamburg, Germany

关键词: Palliative care;    Support needs;    Specialist palliative care;    Psychosocial needs;    Spiritual needs;   

DOI  :  10.1186/s12904-021-00880-6

来源: Springer

【 摘 要 】

BackgroundWe 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).MethodsPts 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.ResultsFour 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).ConclusionNeed 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.

【 授权许可】

CC BY