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Multiple evaluation of a hospital-based palliative care consultation team in a university hospital: Activities, patient outcome, and referring staff's view

Published online by Cambridge University Press:  18 February 2010

Tomoyo Sasahara ,
Mitsunori Miyashita ,
Megumi Umeda ,
Hitomi Higuchi ,
Junko Shinoda ,
Masako Kawa  and
Keiko Kazuma
Tomoyo Sasahara*
Affiliation:
Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
Mitsunori Miyashita
Affiliation:
Department of Adult Nursing/Palliative Care Nursing, School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
Megumi Umeda
Affiliation:
Office Umeda, Tokyo, Japan
Hitomi Higuchi
Affiliation:
Center for Palliative Care, Showa University Hospital, Tokyo, Japan
Junko Shinoda
Affiliation:
Center for Palliative Care, Showa University Hospital, Tokyo, Japan
Masako Kawa
Affiliation:
Palliative Care Support Group, Tokyo, Japan
Keiko Kazuma
Affiliation:
Department of Adult Nursing/Palliative Care Nursing, School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
*
Address correspondence and reprint requests to: Tomoyo Sasahara, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ten-nodai, Tsukuba, 305-8575Japan. E-mail: [email protected]
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Abstract

Objective:

Although the number of hospital-based palliative care consultation teams (PCCTs) is rapidly increasing in Japan, there is limited information available concerning the activities and usefulness of PCCT in the country. The aim of this study is to clarify the activities, patient outcome, and referring staff's view of an established PCCT in Japan.

Method:

This was a prospective study to follow patients referred to a PCCT for 28 days over a 1-year period. Patients were assessed by the Support Team Assessment Schedule–Japanese version (STAS-J) and EORTC QLQ C-30 at the time of referral and on days 7, 14, and 28. A staff survey was implemented using a questionnaire after each observation period.

Results:

Of 180 patients referred, 53 patients were eligible for the study. Although the median of the number of the reasons for referral was 1, the PCCT provided several kinds of support: pain management, 94%; emotional support for the patient, 49%; and emotional support for the family, 36%. On day 7 after referral, of the items of STAS-J and the EORTC QLQ C-30 subscales, only insomnia improved significant whereas “other physical symptoms” and constipation were significantly exacerbated. In the staff survey, of the 98 respondents, more than 90% considered the effect of the PCCT as “excellent” or “good” and were satisfied with the support provided.

Significance of results:

This study showed that the PCCT performed comprehensive assessments on referred patients and provided extra support. No patient's QOL 1 week after referral was improved with the exception of insomnia. Referring staff highly evaluated the activities of the PCCT. In the evaluation of PCCTs, further research about the variation of clinical activities of PCCTs, their applicability, and benefit is needed.

Keywords

Palliative carePalliative care consultation teamConsultationEvaluationUniversity hospital
Type
Original Articles
Information
Palliative & Supportive Care , Volume 8 , Issue 1 , March 2010 , pp. 49 - 57
Copyright
Copyright © Cambridge University Press 2010

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