The main palliative needs of patients with advanced diseases are not physical but psychological, family-related or spiritual. The conclusion is from a multicenter observational study developed by Bárbara Antunes and Pedro Pereira Rodrigues, from CINTESIS – Center for Health Technology and Services Research, presented at the 10th World Congress of the European Association of Palliative Care, held in May in Switzerland.
The main objective of the researchers was to identify the main needs felt by people diagnosed with incurable (oncologic and non-oncologic) and potentially life threatening illnesses with regard to the palliative care they would like to receive.
The authors screened over 1,700 individuals, ultimately including 135 from 9 institutions. More than 80% had cancer, 57% were men and the average age was 66 years. Most were in palliative care units, but there were also patients who were followed up at primary health care units or at non-palliative care hospitals, in different stages of the disease (stable, unstable or terminal).
For patients needing palliative care, the main problem reported was the anxiety or concern of their relatives and friends (36.3%), followed by anxiety or concern about the disease or treatment (13.3% %) and the need to feel at peace (almost 10%). The need to share their emotions was the fifth major palliative necessity referred. Physical needs, such as pain (7.4%) came after these psychological or spiritual needs.
Through the use of a scale called “The Portuguese Integrated Palliative Care Outcome Scale” (IPOS), validated for the Portuguese population, the researchers also concluded that despite being referred, problems often perceived as the most serious, such as vomiting or nausea, were in fact those that least worried the patients.
The study concludes that “clinical teams address physical issues but should improve the resolution of nonphysical needs in palliative care,” suggesting the use of this tool to benefit the palliative clinical practice and improve care for patients and their families.
The work is also signed by Irene Higginson of King’s College London and Pedro Ferreira of the University of Coimbra and was funded by the Calouste Gulbenkian Foundation – Gulbenkian Innovation in Health Program.