posted on 2022-12-22, 15:18authored byMartina O'Reilly
Effective palliative care intervention is contingent upon a comprehensive multidimensional assessment of the patient’s experience of illness. Assessment in palliative care settings must be focused, sensitive, specific and effective in order to minimise discomfort to vulnerable and often highly morbid patients. Optimal assessment can be facilitated by careful choice of tools that allow systematic standardised assessment, are feasible within clinical practice and acceptable to patients.
The aim of this research was the development and testing of evidence based, multidisciplinary, specialist palliative care assessment; accompanying guidelines and training package (the intervention). The tools included in the admission assessment were chosen further to extensive literature review. Mixed methods were utilised to facilitate a comprehensive evaluation pre and post-intervention to test the effectiveness, feasibility and acceptability of the intervention in a busy clinical environment.
Results demonstrated an increase in evidence of assessment across the palliative care domains and in particular in relation to assessment of the patient’s psychosocial distress and assessment of carer’s needs. Post-intervention increased concordance of outcome of clinical assessment with the patients self-rating of pain, nausea, breathlessness and distress is evident in comparison to pre-intervention. Referrals to other disciplines occurred earlier in the admission post-intervention. Staff reported that there was an increase in the assessment of palliative care domains, less need for training and an increased likelihood of assessment of carers needs.
Significant improvement with regard to assessment of patient needs were reported. The admission assessment should be tested in other clinical environments to determine the degree to which the results can be replicated and to investigate concordance with the finding presented here. An adapted version of the assessment should also be developed for the home care and day care services.