Symptom burden, palliative care need and predictors of physical and psychological discomfort in two UK hospitals

BMC Palliative Care

Research Article

Clare Gardiner¹  Tony Ryan²  Christine Ingleton²  Chris Parker² 

[1] School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, S1 4DA, Sheffield, UK;School of Nursing & Midwifery, University of Sheffield, S10 2HQ, Barber House, Sheffield, UK;

关键词: Palliative care;    Burden of illness;    Psychological stress;    Prevalence;    Dementia;    End of life care;    Supportive care;   

DOI  :  10.1186/1472-684X-12-11

 received in 2012-09-05, accepted in 2013-02-18,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundThe requirement to meet the palliative needs of acute hospital populations has grown in recent years. With increasing numbers of frail older people needing hospital care as a result of both malignant and non-malignant conditions, emphasis is being placed upon understanding the physical, psychological and social burdens experienced by patients. This study explores the extent of burden in two large UK hospitals, focusing upon those patients who meet palliative care criteria. Furthermore, the paper explores the use of palliative services and identifies the most significant clinical diagnostic and demographic factors which determine physical and psychological burden.MethodsTwo hospital surveys were undertaken to identify burden using the Sheffield Profile for Assessment and Referral to Care (SPARC). The Gold Standards Framework (GSF) is used to identify those patients meeting palliative care criteria. Participants were identified as being in-patients during a two-week data collection phase for each site. Data was gathered using face-to-face interviews or self-completion by patients or a proxy. Descriptive analyses highlight prevalence and use of palliative care provision. Binary logistic regression assesses clinical diagnostic predictor variables of physical and psychological burden.ResultsThe sample consisted of 514 patients and elevated physical, psychological and social burden is identified amongst those meeting palliative care criteria (n = 185). Tiredness (34.6%), pain (31.1%), weakness (28.8%) and psychological discomfort (low mood 19.9%; anxiety 16.1%) are noted as being prevalent. A small number of these participants accessed Specialist Palliative Care (8.2%). Dementia was identified as a predictor of physical (OR 3.94; p < .05) and psychological burden (OR 2.88; p < .05), being female was a predictor of psychological burden (OR 2.00; p < .05).ConclusionThe paper highlights elevated levels of burden experienced by patients with palliative care requirements. Moreover, the paper also indicates that a large proportion of such patients are not in receipt of palliative approaches to their care. Furthermore, the paper identifies that those with non-malignant illnesses, especially dementia, may experience high levels of physical and psychological burden.

【 授权许可】

CC BY   
© Ryan et al; licensee BioMed Central Ltd. 2013