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Hospital based palliative care teams improve the insight of cancer patients into their disease

Edge Hill College Faculty of Health, University Hospital Aintree, Liverpool; Marie Curie Centre, Liverpool

Valerie Hillier

Imaging, Science and Biomedical Engineering, University of Manchester, Manchester

Anne Williams

School of Health Science, University of Wales, Swansea

Jackie Oldham

Centre For Rehabilitation Science, University of Manchester, Manchester Royal Infirmary, Manchester

It is reported that cancer patients want as much information as possible about their diagnosis and prognosis. This input regarding patients' insight into their disease is undoubtedly a major part of providing optimal palliative care. Despite this, there is little information regarding the impact of hospital based palliative care teams. An evaluation study comprising a nonequivalent control group design, using a quota sample, investigated 100 cancer patients who had been admitted to hospital for symptom control. Fifty patients received hospital palliative care team intervention compared with 50 patients receiving traditional care. Outcome was assessed using the Palliative Care Assessment tool (PACA) assessment tool on three occasions that measured the patients self-reported understanding of their illness. A supplementary qualitative approach that included 31 semistructured interviews with doctors and nurses to explore their perception of the impact of the palliative care team was also undertaken. The results indicated that cancer patients admitted to hospital for symptom control demonstrated an improvement in their insight to their diagnosis. Those patients who had the additional input of the palliative care team had a significantly greater improvement in their insight scores (reported by the doctors and nurses as being invaluable for the patients). Potential explanations are made for these results including enhanced communication skills of the palliative care team are explored.

Key Words: clinical nurse specialists • hospital palliative care teams • insight

Palliative Medicine, Vol. 18, No. 1, 46-52 (2004)
DOI: 10.1191/0269216304pm846oa


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