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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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References

REFERENCES

Abrahm, J.L., Callahan, J., Rossetti, K., et al. (1996). The impact of a hospice consultation team on the care of veterans with advanced cancer. Journal of Pain and Symptom Management, 12, 23–31.CrossRefGoogle Scholar
Axelsson, B. & Christensen, S.B. (1998). Evaluation of a hospital-based palliative support service with particular regard to financial outcome measures. Palliative Medicine, 12, 41–49.CrossRefGoogle ScholarPubMed
Blackford, J. & Street, A. (2001). The role of the palliative care nurse consultant in promoting continuity of end-of-life care. International Journal of Palliative Nursing, 7, 273–278.CrossRefGoogle ScholarPubMed
Braiteh, F., El Osta, B., Palmer, J.L., et al. (2007). Characteristics, findings, and outcomes of palliative care inpatient consultations at a comprehensive cancer center. Journal of Palliative Medicine, 10, 948–955.CrossRefGoogle Scholar
Carter, H., McKinlay, E., Scott, I., et al. (2002). Impact of a hospital palliative care service: Perspective of the hospital staff. Journal of Palliative Care, 18, 160–167.CrossRefGoogle ScholarPubMed
Dunlop, R.J. & Hockley, J.M. (1998). Supporting the professional carers. In Hospital-Based Palliative Care Teams: The Hospital-Hospice Interface, Dunlop, R.J. & Hockley, J.M. (eds.), pp. 111–125. Oxford: Oxford University Press.CrossRefGoogle Scholar
Ellershaw, J.E., Peat, S.J., & Boys, L.C. (1995). Assessing the effectiveness of a hospital palliative care team. Palliative Medicine, 9, 145–152.CrossRefGoogle ScholarPubMed
Fischberg, D. & Meier, D.E. (2004). Palliative care in hospitals. Clinics in Geriatric Medicine, 20, 735–751.CrossRefGoogle ScholarPubMed
Hanks, G.W., Robbins, M., Sharp, D., et al. (2002). The imPaCT study: A randomised controlled trial to evaluate a hospital palliative care team. British Journal of Cancer, 87, 733–739.CrossRefGoogle ScholarPubMed
Hanson, L.C., Usher, B., Spragens, L., et al. (2008). Clinical and economic impact of palliative care consultation. Journal of Pain and Symptom Management, 35, 340–346.CrossRefGoogle ScholarPubMed
Higginson, I.J., Finlay, I., Goodwin, D.M., et al. (2002). Do hospital-based palliative teams improve care for patients or families at the end of life? Journal of Pain and Symptom Management, 23, 96–106.CrossRefGoogle ScholarPubMed
Homsi, J., Walsh, D., Nelson, K.A., et al. (2002). The impact of a palliative medicine consultation service in medical oncology. Supportive Care in Cancer, 10, 337–342.CrossRefGoogle ScholarPubMed
Jack, B., Hillier, V., Williams, A., et al. (2003). Hospital based palliative care teams improve the symptoms of cancer patients. Palliative Medicine, 17, 498–502.CrossRefGoogle ScholarPubMed
Jack, B., Hillier, V., Williams, A., et al. (2004). Hospital based palliative care teams improve the insight of cancer patients into their disease. Palliative Medicine, 18, 46–52.CrossRefGoogle ScholarPubMed
Jack, B., Oldham, J., Williams, A. (2002). Do hospital-based palliative care clinical nurse specialists de-skill general staff? International Journal of Palliative Nursing, 8, 336–340.CrossRefGoogle ScholarPubMed
Kobayashi, K., Takeda, F., Teramukai, S., et al. (1998). A cross-validation of the European Organization for Research and Treatment of Cancer QLQ-C30 (EORTC QLQ-C30) for Japanese with lung cancer. European Journal of Cancer, 34, 767–769.CrossRefGoogle ScholarPubMed
Kuin, A., Courtens, A.M., Deliens, L., et al. (2004). Palliative care consultation in The Netherlands: A nationwide evaluation study. Journal of Pain and Symptom Management, 27, 53–60.CrossRefGoogle ScholarPubMed
Manfredi, P.L., Morrison, R.S., Morris, J., et al. (2000). Palliative care consultations: How do they impact the care of hospitalized patients? Journal of Pain and Symptom Management, 20, 166–173.CrossRefGoogle ScholarPubMed
McDonald, M.V., Passik, S.D., Dugan, W., et al. (1999). Nurses' recognition of depression in their patients with cancer. Oncology Nursing Forum, 26, 593–599.Google ScholarPubMed
Miyashita, M., Matoba, K., Sasahara, T., et al. (2004). Reliability and validity of the Japanese version of the Support Team Assessment Schedule (STAS-J). Palliative & Supportive Care, 2, 379–385.CrossRefGoogle ScholarPubMed
Morita, T., Fujimoto, K., & Imura, C. (2005 a). Trends toward earlier referrals to a palliative care team. Journal of Pain and Symptom Management, 30, 204–205.CrossRefGoogle ScholarPubMed
Morita, T., Fujimoto, K., & Tei, Y. (2005 b). Palliative care team: The first year audit in Japan. Journal of Pain and Symptom Management, 29, 458–465.CrossRefGoogle Scholar
National Council for Palliative Care. (2007). National Survey of Patient Activity Data for Specialist Palliative Care Services. MDS Full Report for the year 2006–2007. London: The National Council for Palliative Care.Google Scholar
Palliative Care Australia. (1999). State of The Nation 1998: Report of National Census of Palliative Care Services. Canberra, Australia: Palliative Care Australia.Google Scholar
Pan, C.X., Morrison, R.S., Meier, D.E., et al. (2001). How prevalent are hospital-based palliative care programs? Status report and future directions. Journal of Palliative Medicine, 4, 315–324.CrossRefGoogle ScholarPubMed
Rabow, M.W., Dibble, S.L., Pantilat, S.Z., et al. (2004). The comprehensive care team: A controlled trial of outpatient palliative medicine consultation. Archives of Internal Medicine, 164, 83–91.CrossRefGoogle Scholar
Sasahara, T., Sanjo, M., Umeda, M., et al. (2008). What kind of support does hospital-based palliative care team provide in a university hospital? A result from participant-observation approach. Journal of Japanese Society of Cancer Nursing, 22, 12–22(in Japanese).Google Scholar
Schrijinemaekers, V., Courtens, A., van den Beuken, M., et al. (2003). The first 2 years of a palliative care consultation team in the Netherlands. International Journal of Palliative Nursing, 9, 252–257.CrossRefGoogle ScholarPubMed
Sepulveda, C., Marlin, A., Yoshida, T., et al. (2002). Palliative care: The World Health Organization's global perspective. Journal of Pain and Symptom Management, 24, 91–96.CrossRefGoogle ScholarPubMed
Stromgren, A.S., Sjogren, P., Goldschmidt, D., et al. (2005). A longitudinal study of palliative care: Patient-evaluated outcome and impact of attrition. Cancer, 103, 1747–1755.CrossRefGoogle ScholarPubMed
Tada, T., Hashimoto, F., Matsushita, Y., et al. (2004). Investigation of QOL of hospice patients by using EORTC-QLQ-C30 questionnaire. Journal of Medical Investigation, 51, 125–131.CrossRefGoogle ScholarPubMed
Vernooij-Dassen, M.J., Groot, M.M., van den Berg, J., et al. (2007). Consultation in palliative care: The relevance of clarification of problems. European Journal of Cancer, 43, 316–322.CrossRefGoogle ScholarPubMed
Virik, K. & Glare, P. (2002). Profile and evaluation of a palliative medicine consultation service within a tertiary teaching hospital in Sydney, Australia. Journal of Pain and Symptom Management, 23, 17–25.CrossRefGoogle ScholarPubMed
Yoshimoto, T., Ishino, Y., Hisada, S., et al. (2005). A palliative care team in a general hospital improves the physical symptoms of patients. Japanese Journal of Palliative Medicine, 7, 301–308(in Japanese).Google Scholar
Zhukovsky, D.S. (2000). A model of palliative care: The palliative medicine program of the Cleveland Clinic Foundation. A World Health Organization Demonstrations Project. Supportive Care in Cancer, 8, 268–277.Google Scholar