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      Development of the Palliative Care Needs Assessment Tool (PC-NAT) for use by multi-disciplinary health professionals

      Author(s): 1 , 1 , 2 , 1
      Publication date Created:
      Publication date (Electronic):
      Journal: Palliative Medicine
      Publisher: SAGE Publications

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          Abstract

          Needs assessment strategies can facilitate prioritisation of resources. To develop a needs assessment tool for use with advanced cancer patients and caregivers, to prompt early intervation. A convenience sample of 103 health professionals viewed three videotaped consultations involving a simulated patient, his/her caregiver and a health professional, completed the Palliative Care Needs Assessment Tool (PC-NAT) and provided feedback on clarity, content and acceptability of the PC-NAT. Face and content validity, acceptability and feasibility of the PC-NAT were confirmed. Kappa scores indicated adequate inter-rater reliability for the majority of domains; the patient spirituality domain and the caregiver physical and family and relationship domains had low reliability. The PC-NAT can be used by health professionals with a range of clinical expertise to identify individuals' needs, thereby enabling early intervention. Further psychometric testing and an evaluation to assess the impact of the systematic use of the PC-NAT on quality of life, unmet needs and service utilisation of patients and caregivers are underway.

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          Spirituality and meaning in supportive care: spirituality- and meaning-centered group psychotherapy interventions in advanced cancer.

          William Breitbart (2002)
          Existential and spiritual issues are at the frontier of new clinical and research focus in palliative and supportive care of cancer patients. As concepts of adequate supportive care expand beyond a focus on pain and physical symptom control, existential and spiritual issues such as meaning, hope and spirituality in general have received increased attention from supportive care clinicians and clinical researchers. This paper reviews the topics of spirituality and end-of-life care, defines spirituality, and suggests measures of spirituality that deal with two of its main components: faith/religious beliefs and meaning/spiritual well-being. These two constructs of spirituality are reviewed in terms of their role in supportive care. Finally, a review of existing psychotherapeutic interventions for spiritual suffering are reviewed and a novel meaning-centered group psychotherapy for advanced cancer patients is described.
          Article 0 comments Cited 84 times – based on 0 reviews     Review now
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            Cancer and caregiving: the impact on the caregiver's health.

            C Nijboer, R Tempelaar, R Sanderman … (1998)
            A diagnosis of cancer affects not only the patient but also their significant others, especially when a lot of care tasks are involved. Some caregivers perceive the care as a burden, while others consider it a challenge. In this article, findings concerning the impact of cancer caregiving on informal caregivers will be described. No consistent results are reported, and little is known about patterns of caregiving changes in relation to the course of the patient's illness. Attention will be given to factors which have been identified as influencing the course and consequences of caregiving. These factors form the basis of a conceptual research model for caregivers of cancer patients. As cancer progresses, care tasks are generated, which can be perceived by the caregiver as either negative (i.e. burden) or positive. Furthermore, these caregiver experiences may lead to negative as well as positive effects on the caregiver's health and these relationships can be assumed to be bidirectional.
            Article 0 comments Cited 57 times – based on 0 reviews     Review now
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              Do hospital-based palliative teams improve care for patients or families at the end of life?

              Irene J Higginson, Ilora Finlay, Danielle M Goodwin … (2002)
              To determine whether hospital-based palliative care teams improve the process or outcomes of care for patients and families at the end of life, a systematic literature review was performed employing a qualitative meta-synthesis and quantitative meta-analysis. Ten databases were searched. This was augmented by hand searching specific journals, contacting authors, and examining the reference lists of all papers retrieved. Studies were included if they evaluated palliative care teams working in hospitals. Data were extracted by two independent reviewers. Studies were graded using two independent hierarchies of evidence. A Signal score was used to assess the relevance of publications. Two analyses were conducted. In a qualitative meta-synthesis data were extracted into standardized tables to compare relevant features and findings. In quantitative meta-analysis we calculated the effect size of each outcome (dividing the estimated mean difference or difference in proportions by the sample's standard deviation). Nine studies specifically examined the intervention of a hospital-based palliative care team or studies. A further four studies considered interventions that included a component of a hospital or support team, although the total intervention was broader. The nature of the interventions varied. The studies were usually in large teaching hospitals, in cities, and mainly in the United Kingdom. Outcomes considered symptoms, quality of life, time in hospital, total length of time in palliative care, or professional changes, such as prescribing practices. Only one of the studies was a randomized controlled trial and this considered a hospital team as part of other services. Most method scores indicated limited research quality. Comparison groups were subject to bias and the analyses were not adjusted for confounding variables. In addition, there were problems of attrition and small sample sizes. Nevertheless, all studies indicated a small positive effect of the hospital team, except for one study in Italy, which documented deterioration in patient symptoms. The Signal scores indicated that the studies were relevant. No study compared different models of hospital team. This review suggests that hospital-based palliative care teams offer some benefits, although this finding should be interpreted with caution. The study designs need to be improved and different models of providing support at the end of life in hospital need comparison. Standardized outcome measures should be used in such research and in practice.
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                Author and article information

                Journal
                Title: Palliative Medicine
                Abbreviated Title: Palliat Med
                Publisher: SAGE Publications
                ISSN (Print): 0269-2163
                ISSN (Electronic): 1477-030X
                Publication date Created: October 06 2008
                Publication date Created: December 2008
                Publication date (Electronic): October 06 2008
                Publication date (Print): December 2008
                Volume: 22
                Issue: 8
                Pages: 956-964
                Affiliations
                [1 ]Centre for Health Research & Psycho-oncology, School of Medicine & Public Health, The Cancer Council NSW, University of Newcastle & Hunter Medical Research Institute, Newcastle
                [2 ]Department of Palliative and Supportive Services, Flinders University, Adelaide
                Article
                DOI: 10.1177/0269216308098797
                PubMed ID: 18952754
                SO-VID: 2b94c2cf-f40e-4a2e-8a81-f8d1fe6b9714
                Copyright © © 2008
                License:

                http://journals.sagepub.com/page/policies/text-and-data-mining-license

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