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Professionally perceived effectiveness of psychosocial interventions for existential suffering of terminally ill cancer patients.

Abstract：

BACKGROUND:Although integrated care for existential suffering is an essential part of palliative care, little is known about its concept and efficacy as perceived by professionals. A questionnaire survey was carried out to 1) explore the underlying structure of psychosocial interventions recommended by specialists, 2) identify the professionally perceived effectiveness of each intervention for specific existential distress, and 3) examine the effects of specialty on their recommendations. METHODS:A questionnaire with three scenarios representing terminally ill cancer patients with uncertainty-related anxiety, guilt feelings, and dependency-related meaninglessness was mailed to 701 Japanese psychiatrists, 118 psychologists, and 372 palliative care nurses. RESULTS:A total of 456 responses were obtained (response rate = 38%). Recommended psychosocial interventions were classified into six subcategories: 'a supportive-expressive approach,' 'providing comfortable environments,' 'meaning-centered approach,' 'being,' 'education and coping skills training,' and 'a religious approach.' A 'supportive-expressive approach' was consistently recommended in all vignettes. On the other hand, 'providing comfortable environments' was most recommended for patients with uncertainty-related anxiety, and a 'meaning-centered approach' and 'being' were most recommended for patients feeling dependency-related meaninglessness. Psychiatrists estimated the effectiveness of psychopharmacological treatment significantly higher than psychologists and nurses, while nurses evaluated efficacy of all other interventions significantly higher than psychiatrists and psychologists. CONCLUSIONS:Experts evaluated a variety of clinical interventions as effective in palliating existential suffering, although the perceived levels of efficacy of each intervention differed according to the nature of suffering and their specialties. To effectively alleviate existential suffering in terminally ill cancer patients, an integrated care by an interdisciplinary team is necessary.

journal_name

Palliat Med

journal_title

Palliative medicine

authors

Hirai K,Morita T,Kashiwagi T

doi

10.1191/0269216303pm825oa

subject

Has Abstract

pub_date

2003-12-01 00:00:00

pages

688-94

issue

eissn

0269-2163

issn

1477-030X

journal_volume

pub_type

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Professionally perceived effectiveness of psychosocial interventions for existential suffering of terminally ill cancer patients.