Psychological assessment and the role of the psychologist in early palliative care
BackgroundEarly palliative care (EPC) is a recommended model for improving the quality of life for patients with advanced cancer and their caregivers. However, limited research has focused on the role of psychological evaluation within EPC. The Veneto Institute of Oncology (IOV), a Comprehensive Can...
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Frontiers Media S.A.
2024-11-01
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| Series: | Frontiers in Psychology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyg.2024.1437191/full |
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| author | Pamela Iannizzi Alessandra Feltrin Rosalba Martino Chiara De Toni Antonella Galiano Ardi Pambuku Mariateresa Nardi Nicla Meraviglia Antonella Brunello Vittorina Zagonel |
| author_facet | Pamela Iannizzi Alessandra Feltrin Rosalba Martino Chiara De Toni Antonella Galiano Ardi Pambuku Mariateresa Nardi Nicla Meraviglia Antonella Brunello Vittorina Zagonel |
| author_sort | Pamela Iannizzi |
| collection | DOAJ |
| description | BackgroundEarly palliative care (EPC) is a recommended model for improving the quality of life for patients with advanced cancer and their caregivers. However, limited research has focused on the role of psychological evaluation within EPC. The Veneto Institute of Oncology (IOV), a Comprehensive Cancer Centre, employs an interdisciplinary team to assess patients with advanced-stage disease. This study aims to assess the psychological needs of these patients, investigate any correlations between psychological symptoms (PSs) and factors such as awareness of diagnosis and prognosis, symptoms detected using the Edmonton Symptom Assessment System (ESAS), as well as the patient’s gender, age, social issues, and survival and to clarify the psychologist’s role within the interdisciplinary team.MethodsData were retrieved from a prospectively maintained database. From 1st January 2018 to 31st December 2021, 819 consecutive patients were evaluated during EPC consultations, with 753 participants enrolled in the study. The ESAS was administered to each patient before the consultation.ResultsMore than half of the patients (385, 57.1%) reported at least one PS, with an ESAS score of ≥4. Specifically, 34.9% reported depression, 28.7% reported anxiety, and 43.2% indicated feeling “not well.” Referring oncologists tended to overestimate the presence of PSs compared to patient self-reports (51.8% versus 41.3%). According to the psychologists’ assessment, 29.2% of participants were found to have depression, and 10.8% of participants had anxiety. Additionally, 31 patients (10.8%) with psychological disorders were diagnosed with an adaptation disorder related to a physical condition. The psychology service engaged 47% of patients, while 18.5% declined psychological support. Patients exhibiting other ESAS symptoms with scores of ≥4 had an increased odds ratio for reporting PSs of ≥4. However, multivariable analysis revealed no significant relationship between PSs and awareness of diagnosis and prognosis.ConclusionThe systematic use of self-assessment in EPC is essential for understanding patient’s experience, determining whether PSs stem from physical disorders, and prioritizing interventions. Awareness of prognosis does not correlate with increased anxiety and depression in patients. Therefore, EPC is an ideal opportunity to discuss prognosis and facilitate patients’ end-of-life choices early in their care journey. |
| format | Article |
| id | doaj-art-dcf6b7de0dc34d0bb092c00d9f68d969 |
| institution | Kabale University |
| issn | 1664-1078 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychology |
| spelling | doaj-art-dcf6b7de0dc34d0bb092c00d9f68d9692024-11-13T12:13:24ZengFrontiers Media S.A.Frontiers in Psychology1664-10782024-11-011510.3389/fpsyg.2024.14371911437191Psychological assessment and the role of the psychologist in early palliative carePamela Iannizzi0Alessandra Feltrin1Rosalba Martino2Chiara De Toni3Antonella Galiano4Ardi Pambuku5Mariateresa Nardi6Nicla Meraviglia7Antonella Brunello8Vittorina Zagonel9Hospital Psychology, Veneto Institute of Oncology IOV – IRCCS, Padua, ItalyHospital Psychology, Veneto Institute of Oncology IOV – IRCCS, Padua, ItalyHospital Psychology, Veneto Institute of Oncology IOV – IRCCS, Padua, ItalyDepartment of Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV – IRCCS, Padua, ItalyDepartment of Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV – IRCCS, Padua, ItalyPain Therapy and Palliative Care Unit, Veneto Institute of Oncology IOV – IRCCS, Padua, ItalyClinical Nutrition Unit, Veneto Institute of Oncology IOV – IRCCS, Padua, ItalyHospital Psychology, Veneto Institute of Oncology IOV – IRCCS, Padua, ItalyDepartment of Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV – IRCCS, Padua, ItalyDepartment of Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV – IRCCS, Padua, ItalyBackgroundEarly palliative care (EPC) is a recommended model for improving the quality of life for patients with advanced cancer and their caregivers. However, limited research has focused on the role of psychological evaluation within EPC. The Veneto Institute of Oncology (IOV), a Comprehensive Cancer Centre, employs an interdisciplinary team to assess patients with advanced-stage disease. This study aims to assess the psychological needs of these patients, investigate any correlations between psychological symptoms (PSs) and factors such as awareness of diagnosis and prognosis, symptoms detected using the Edmonton Symptom Assessment System (ESAS), as well as the patient’s gender, age, social issues, and survival and to clarify the psychologist’s role within the interdisciplinary team.MethodsData were retrieved from a prospectively maintained database. From 1st January 2018 to 31st December 2021, 819 consecutive patients were evaluated during EPC consultations, with 753 participants enrolled in the study. The ESAS was administered to each patient before the consultation.ResultsMore than half of the patients (385, 57.1%) reported at least one PS, with an ESAS score of ≥4. Specifically, 34.9% reported depression, 28.7% reported anxiety, and 43.2% indicated feeling “not well.” Referring oncologists tended to overestimate the presence of PSs compared to patient self-reports (51.8% versus 41.3%). According to the psychologists’ assessment, 29.2% of participants were found to have depression, and 10.8% of participants had anxiety. Additionally, 31 patients (10.8%) with psychological disorders were diagnosed with an adaptation disorder related to a physical condition. The psychology service engaged 47% of patients, while 18.5% declined psychological support. Patients exhibiting other ESAS symptoms with scores of ≥4 had an increased odds ratio for reporting PSs of ≥4. However, multivariable analysis revealed no significant relationship between PSs and awareness of diagnosis and prognosis.ConclusionThe systematic use of self-assessment in EPC is essential for understanding patient’s experience, determining whether PSs stem from physical disorders, and prioritizing interventions. Awareness of prognosis does not correlate with increased anxiety and depression in patients. Therefore, EPC is an ideal opportunity to discuss prognosis and facilitate patients’ end-of-life choices early in their care journey.https://www.frontiersin.org/articles/10.3389/fpsyg.2024.1437191/fulladvanced cancer patientsearly palliative carepsycho-oncologypsychological assessmentshare care planning |
| spellingShingle | Pamela Iannizzi Alessandra Feltrin Rosalba Martino Chiara De Toni Antonella Galiano Ardi Pambuku Mariateresa Nardi Nicla Meraviglia Antonella Brunello Vittorina Zagonel Psychological assessment and the role of the psychologist in early palliative care Frontiers in Psychology advanced cancer patients early palliative care psycho-oncology psychological assessment share care planning |
| title | Psychological assessment and the role of the psychologist in early palliative care |
| title_full | Psychological assessment and the role of the psychologist in early palliative care |
| title_fullStr | Psychological assessment and the role of the psychologist in early palliative care |
| title_full_unstemmed | Psychological assessment and the role of the psychologist in early palliative care |
| title_short | Psychological assessment and the role of the psychologist in early palliative care |
| title_sort | psychological assessment and the role of the psychologist in early palliative care |
| topic | advanced cancer patients early palliative care psycho-oncology psychological assessment share care planning |
| url | https://www.frontiersin.org/articles/10.3389/fpsyg.2024.1437191/full |
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