Palliative Care Gaps in Providing Psychological Treatment: A Review of the Current State of Research in Multidisciplinary Palliative Care

Abstract

The majority of analyzed studies failed to describe how psychological symptoms were identified and treated, which discipline on the team provided the treatment, and whether psychological symptoms improved as a result of the intervention. Future research evaluating the effects of palliative care interventions on psychological symptoms will benefit from using reliable and valid psychological outcome measures and providing specificity regarding the psychological components of the intervention and who provides it.

Palliative Care Providers’ Practices Surrounding Psychological Distress Screening and Treatment: A National Survey

“…Furthermore, there is currently a gap in evidence-based practices in regard to managing psychological distress in palliative care. 10 More research is needed to establish and disseminate to all relevant disciplines evidence-based interventions to treat psychological distress in palliative care. Additionally, future qualitative studies could help to illuminate why and when palliative care providers refer patients to various disciplines for psychological care.…”

“…A recent systematic review of palliative care interventions revealed that multicomponent palliative care interventions that purport to provide psychological care routinely fail to document the type of psychological treatment being provided, who is providing it, and whether it is effective. 10 This review further revealed that in the research setting, the most frequent mental health screen was the Edmonton Symptom Assessment Scale, 10 a multidimensional palliative care screening instrument that is commonly used despite the fact that its reliability and validity as a screening tool for psychological symptoms such as anxiety and depression has not been established. 11 While treating psychological distress is a critical component of what palliative care teams do, it is unclear whether teams in practice are currently doing so based on the “best available evidence.”…”

Exploring the psychological impact of life‐limiting illness using the Attitude to Health Change scales: A qualitative focus group study in a hospice palliative care setting

“…The psychological needs of patients and family carers may range from information giving and compassionate communication to more formal or specialist psychological interventions such as counselling (Kozlov, Niknejad, & Reid, 2018). In the UK, national guidance recommends four levels of psychological support (Figure 1), with those with more complex needs requiring support from counsellors, psychologists, psychotherapists, mental health nurses or psychiatrists (National Institute & for Health & Care Excellence, 2004).…”

“…Psychological symptoms can be underestimated as they are assumed to be expected in this population (O'Malley et al., 2020). Symptoms such as fatigue may be mistaken for side effects of underlying disease or treatment (Boakye et al., 2019), and it can be unclear whose role it is to provide psychological care (Kozlov et al., 2018). Practitioners also often avoid or are reluctant to engage in conversations that acknowledge uncertainty because of lack of confidence and fear of taking away hope (Almack, Cox, Moghaddam, Pollock, & Seymour, 2012).…”

Evaluation of the psychiatry consultations of inpatients in Palliative Care Unit of Adiyaman Training and Research Hospital: 2018 data

“…The subdivision of medicine, which has become inevitable to large accumulation of clinical and scientific knowledge, has limited the possibilities of joint decision-making under various specialties and subspecialties. [4] Psychiatry and palliative care are fields that address patients with mental distress and are living in their final stages of life. Both fields are less convenient than other medical fields for biomedical interventions.…”