What makes palliative care needs “complex”? A multisite sequential explanatory mixed methods study of patients referred for specialist palliative care
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 healthc...
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doaj-6f853d3920554e3b8896d4adc7039ec02021-01-17T12:26:25ZengBMCBMC Palliative Care1472-684X2021-01-0120111110.1186/s12904-020-00700-3What makes palliative care needs “complex”? A multisite sequential explanatory mixed methods study of patients referred for specialist palliative careAnne M. Finucane0Connie Swenson1John I. MacArtney2Rachel Perry3Hazel Lamberton4Lucy Hetherington5Lisa Graham-Wisener6Scott A. Murray7Emma Carduff8Marie Curie Hospice EdinburghMarie Curie Hospice EdinburghUnit of Academic Primary Care, University of WarwickMarie Curie Hospice West MidlandsMarie Curie Hospice BelfastMarie Curie Hospice GlasgowCentre for Improving Health-Related Quality of Life, School of Psychology, Queen’s University BelfastPrimary Palliative Care Research Group, Usher Institute, University of EdinburghMarie Curie Hospice GlasgowAbstract 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.https://doi.org/10.1186/s12904-020-00700-3 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Anne M. Finucane Connie Swenson John I. MacArtney Rachel Perry Hazel Lamberton Lucy Hetherington Lisa Graham-Wisener Scott A. Murray Emma Carduff |
spellingShingle |
Anne M. Finucane Connie Swenson John I. MacArtney Rachel Perry Hazel Lamberton Lucy Hetherington Lisa Graham-Wisener Scott A. Murray Emma Carduff What makes palliative care needs “complex”? A multisite sequential explanatory mixed methods study of patients referred for specialist palliative care BMC Palliative Care |
author_facet |
Anne M. Finucane Connie Swenson John I. MacArtney Rachel Perry Hazel Lamberton Lucy Hetherington Lisa Graham-Wisener Scott A. Murray Emma Carduff |
author_sort |
Anne M. Finucane |
title |
What makes palliative care needs “complex”? A multisite sequential explanatory mixed methods study of patients referred for specialist palliative care |
title_short |
What makes palliative care needs “complex”? A multisite sequential explanatory mixed methods study of patients referred for specialist palliative care |
title_full |
What makes palliative care needs “complex”? A multisite sequential explanatory mixed methods study of patients referred for specialist palliative care |
title_fullStr |
What makes palliative care needs “complex”? A multisite sequential explanatory mixed methods study of patients referred for specialist palliative care |
title_full_unstemmed |
What makes palliative care needs “complex”? A multisite sequential explanatory mixed methods study of patients referred for specialist palliative care |
title_sort |
what makes palliative care needs “complex”? a multisite sequential explanatory mixed methods study of patients referred for specialist palliative care |
publisher |
BMC |
series |
BMC Palliative Care |
issn |
1472-684X |
publishDate |
2021-01-01 |
description |
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. |
url |
https://doi.org/10.1186/s12904-020-00700-3 |
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