What defines the comprehensive assessment of needs in palliative care? An integrative systematic review

Goni-Fuste, Blanca; Crespo, Iris; Monforte-Royo, Cristina; Porta-Sales, Josep; Balaguer, Albert; Pergolizzi, Denise

doi:10.1177/0269216321996985

Cited by 13 publications

(13 citation statements)

References 95 publications

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“…This finding is consistent with the results from a systematic review that found formal assessments accurately captured patients’ physical and psychological needs, but conversations elicited broader communication of concerns. 54 The findings here suggest that implementing open conversations leads to a more comprehensive understanding of the complexity of issues that can be experienced in more than one domain of care.…”

Section: Summary Of the Evidencementioning

confidence: 74%

The concept of holism applied in recent palliative care practice: A scoping review

Bryk

Roberts²,

Hudson

et al. 2022

Palliat Med

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Background: Whilst there is a sense of holism existing within palliative care practice, what is not clear is the extent to which holism, as applied in recent palliative care practice, has been adequately researched. Currently, no reviews on this topic were identified through systematic and scoping review registries. Aim: To identify and describe the available published evidence on the key features of holism and the core domains underpinning the application of holism in relation to recent palliative care practice. Design: Scoping review using the Johanna Briggs Institute design. Data sources: MEDLINE, EMCARE, and CINAHL (Ovid), PsycINFO, SocINDEX, SCOPUS and Web of Science. (International, peer-reviewed, published papers in the English language from January 2010to December 2020). Results: Five studies met inclusion criteria. Two studies used qualitative methods, one used mixed-methods, and two were randomised controlled trials. The research investigated (1) frameworks for holistic care and (2) assessment tools applied in palliative care settings. Conclusions: The results from the review led to identifying key features of palliative care that were presented as interconnected aspects of holistic care domains in both assessments and interventions. The literature revealed a focus on curative and biomedical approaches to disease management with holistic aspects acknowledged, but not in the forefront of core service delivery. Holism was generally conceptualised as an overarching theoretical framework to palliative care service provision and positioned as an adjunct to palliative models of care. These findings point to a gap in research that links the concept of holism to applied palliative care practices.

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Section: Summary Of the Evidencementioning

confidence: 74%

The concept of holism applied in recent palliative care practice: A scoping review

Bryk

Roberts²,

Hudson

et al. 2022

Palliat Med

View full text Add to dashboard Cite

show abstract

“…Forty-eight reviews synthesised patient preferences for patient-centred end-of-life care. 7,8,11,41 –85 A total of five major themes associated with patient preferences were developed: (1) shared decision-making; (2) communication and end-of-life conversations; (3) spiritual, cultural, and religious support; (4) compassionate and humanitarian care; and (5) the physical healthcare environment. A detailed summary of these themes, alongside a des-cription of the findings associated with each theme, has been presented in Table 4.…”

Section: Resultsmentioning

confidence: 99%

A rapid umbrella review of the literature surrounding the provision of patient-centred end-of-life care

et al. 2023

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Background: Patients have reported a broad range of unmet needs in their receipt of clinical care at the end of life. Therefore, enhancing the quality of end-of-life care through patient-centred healthcare interactions is warranted. Aim: The aim of this rapid umbrella review was to synthesise previous literature reviews that have examined: (1) patient preferences for patient-centred end-of-life care; (2) barriers and enablers to patient-centred end-of-life care; (3) interventions designed to enhance patient-centred end-of-life care; and (4) patient-centred models of end-of-life care. Design: A rapid umbrella review was conducted and informed by the Joanna Briggs Institute’s methodological guidance for conducting umbrella reviews. Data sources: Three academic databases were searched for relevant literature in May 2022: MEDLINE, PsycINFO and CINAHL Plus. Inclusion criteria encompassed literature reviews that examined the topic of patient-centred care for any adult patients in end-of-life care. Results: A total of 92 literature reviews were identified. Findings suggest that there is often a discrepancy between patient preferences and the provision of care. These discrepancies have been associated with a range of barriers at the patient, staff and system levels. Common interventions included education and training for staff which were often met with improved patient outcomes. Patient-centred models of care were underrepresented across the literature. Conclusions: This review highlighted a need for healthcare systems to support staff in providing a patient-centred end of life experience through the development of a co-designed patient-centred model of care, supplemented by professional development and a systematic approach to identifying and documenting patient preferences.

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“…Person-centred care may be understood to focus on a conclusive list of needs in people with dementia [ 101 ], but Goni-Fuste et al found in their systematic review, that evidence is fragmented about the content of the respective domains (physical, psycho-social, and spiritual) within a holistic needs assessment [ 104 ]. The authors found that the domains differ in meaning indicating that there is no holistic needs assessment fit for all life-limiting illnesses such as dementia [ 104 ].…”

Section: Discussionmentioning

confidence: 99%

Are nurse`s needs assessment methods robust enough to recognise palliative care needs in people with dementia? A scoping review

et al. 2022

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Background People with dementia are most at risk of experiencing serious health related suffering, if they do not have a palliative care approach introduced early enough in the illness. It can be challenging for nurses to assess experienced needs of people, who are thought no longer able to self-report such as people with dementia. Assessment help to understand the care the patient and their family need promptly. It is unknown how nurses recognise holistic palliative care needs in people with dementia during routine care. Methods Scoping review where EMBASE, MEDLINE, CINAHL, PsycInfo databases, and references were searched with an advanced search strategy, which was built on three concepts (nurses, dementia, and nursing assessment) using corresponding Medical Subject Headings. Data were charted in a piloted extraction form, based on the assessment domains within the nursing process followed by summarise and synthesise results narratively. Results 37 out of 2,028 qualitative and quantitative articles published between 2000 and 2021, and relating to 2600 + nurses, were identified. Pain was sole focus of assessment in 29 articles, leaving 8 articles to describe assessment of additional needs (e.g., discomfort). Nurses working in a nursing home assess pain and other needs by observing the persons with dementia behaviour during routine care. Nurses in the acute care setting are more likely to assess symptoms with standard assessment tools at admission and evaluate symptoms by observational methods. Across settings, about one third of pain assessments are supported by person-centred pain assessment tools. Assessments were mostly triggered when the person with dementia vocalised discomfort or a change in usual behaviour was observed. Nurses rely on family members and colleagues to gain more information about needs experienced by people with dementia. Conclusion There is a scarcity of evidence about techniques and methods used by nurses to assess needs other than pain experienced by people with dementia. A holistic, person-centred screening tool to aid real-time observations at the bedside and used in conversations with health care professionals and families/friends, may improve need recognition other than pain, to ensure holistic needs could then be addressed timely to improve care in people with dementia.

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What defines the comprehensive assessment of needs in palliative care? An integrative systematic review

Cited by 13 publications

References 95 publications

The concept of holism applied in recent palliative care practice: A scoping review

The concept of holism applied in recent palliative care practice: A scoping review

A rapid umbrella review of the literature surrounding the provision of patient-centred end-of-life care

Are nurse`s needs assessment methods robust enough to recognise palliative care needs in people with dementia? A scoping review

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