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What makes palliative care needs “complex”? A multisite sequential explanatory mixed methods study of patients referred for specialist palliative care
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Finucane, Anne, Swenson, Connie, MacArtney, John I., Perry, Rachel, Lamberton, Hazel, Hetherington, Lucy, Graham-Wisener, Lisa, Murray, Scott and Carduff, Emma (2021) What makes palliative care needs “complex”? A multisite sequential explanatory mixed methods study of patients referred for specialist palliative care. BMC Palliative Care, 20 . 18. doi:10.1186/s12904-020-00700-3 ISSN 1472-684X.
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Official URL: https://doi.org/10.1186/s12904-020-00700-3
Abstract
Background:
Specialist palliative care (SPC) providers tend to use the term ‘complex’ to refer to the needs of patients who require SPC. However, little is known about complex needs on first referral to a SPC service. We examined which needs are present and sought the perspectives of healthcare professionals on the complexity of need on referral to a hospice service.
Methods:
Multi-site sequential explanatory mixed method study consisting of a case-note review and focus groups with healthcare professionals in four UK hospices.
Results:
Documentation relating to 239 new patient referrals to hospice was reviewed; and focus groups involving 22 healthcare professionals conducted. Most patients had two or more needs documented on referral (96%); and needs were recorded across two or more domains for 62%. Physical needs were recorded for 91% of patients; psychological needs were recorded for 59%. Spiritual needs were rarely documented. Referral forms were considered limited for capturing complex needs. Referrals were perceived to be influenced by the experience and confidence of the referrer and the local resource available to meet palliative care needs directly.
Conclusions:
Complexity was hard to detail or to objectively define on referral documentation alone. It appeared to be a term used to describe patients whom primary or secondary care providers felt needed SPC knowledge or support to meet their needs. Hospices need to provide greater clarity regarding who should be referred, when and for what purpose. Education and training in palliative care for primary care nurses and doctors and hospital clinicians could reduce the need for referral and help ensure that hospices are available to those most in need of SPC input.
| Item Type: | Journal Article | ||||||
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| Subjects: | R Medicine > RA Public aspects of medicine R Medicine > RT Nursing |
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Care of the sick, Palliative treatment, Medical care, Hospice care | ||||||
| Journal or Publication Title: | BMC Palliative Care | ||||||
| Publisher: | BioMed Central Ltd. | ||||||
| ISSN: | 1472-684X | ||||||
| Official Date: | 15 January 2021 | ||||||
| Dates: |
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| Volume: | 20 | ||||||
| Article Number: | 18 | ||||||
| DOI: | 10.1186/s12904-020-00700-3 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||
| Date of first compliant deposit: | 8 February 2021 | ||||||
| Date of first compliant Open Access: | 8 February 2021 | ||||||
| RIOXX Funder/Project Grant: |
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