Psychosocial care provided by physicians and nurses in palliative care: A mixed methods study

• Published in: Journal of pain and symptom management 2017-02, Vol.53 (2), p.216-223
• Main Authors: Fan, Sheng-Yu, PhD, Lin, I-Mei, PhD, Hsieh, Jyh-Gang, MD, Chang, Chih-Jung, BS
• Format: Article
• Language: English
• Subjects: Anesthesia & Perioperative Care; Clinical psychologists; Counseling; Counselling psychologists; Disease; Dynamic assessment; Family support; Health Care Surveys; Humans; medical staff; Mental health care; Mental health services; Mixed methods research; Needs assessment; Nurses; Pain Medicine; Palliative care; Palliative Care - methods; Physicians; Psychologists; Psychosocial care; Psychosocial factors; Quality of care; Research methodology; Social support; Social workers; Taiwan; Teams
• ISSN: 0885-3924; 1873-6513
• DOI: 10.1016/j.jpainsymman.2016.08.019

Abstract Context Psychosocial care is an important component of palliative care, which is also provided by physicians and nurses. Objective The aim of this study was to explore the experiences of physicians and nurses in palliative care regarding the process of psychosocial care, the difficulties, and the support needs from psychosocial care professionals. Methods A two-phase mixed methods study was conducted. In the first phase, 16 physicians and nurses with palliative care experience were recruited. A semi-structured interview was used to collect data about their experience of providing psychosocial care, and these were analyzed using thematic analysis. In the second phase, 88 physicians and nurses completed an online survey that was developed from the qualitative results. Results Qualitative results revealed three themes: (1) the contents of psychosocial care included not only disease-related events but also emotional and family support. (2) Providing psychosocial care was a dynamic process including assessment, interventions, and evaluation. (3) There were difficulties from the participants themselves, patients and families, and the system. Participants also reflected on what they did and the influences of providing care on themselves. Quantitative results showed that the most common psychosocial care was discussion about the progress of the disease and future care plan; the difficulty was the long-term problems in families; and the psychosocial care professionals most needed were social workers and clinical/counseling psychologists. Conclusions Understanding the process of psychosocial care and integrating it with specialized mental health care in a team could improve the quality of psychosocial care in palliative care.