Psychosocial palliative care - patients preferences and priorities

An article written by Emeritus Professor Kenneth Pakenham and Christopher Lloyd Martin

Significant levels of distress are experienced by 29-40% of palliative patients. Access to effective psychosocial interventions which reduce distress and enhance wellbeing and quality of life is essential. Therefore, we undertook a study to ask 81 palliative care patients 3 key survey questions about their needs for psychosocial support: [1]

1) how would they like to receive support?

2) what psychosocial areas they would like support with?

3) and what their main wellbeing priorities were whilst living with a palliative illness, and at the end of their life?

Answers to the first question showed that most palliative patients (85%) wanted to receive psychosocial support via in-person appointments as their first preference. This stands in contrast to the recent accelerated uptake of telehealth and self-help approaches prompted by the COVID-19 pandemic.

Responses to the second question showed that improving quality of life was the number one area palliative patients wanted support with. This was followed by preferences for assistance with distressing emotions and adjusting to living with a palliative illness.

Lastly, answers to the third question showed that whilst living with a palliative illness, the key wellbeing needs were spending time with loved ones and continuing to engage in valued activities, whilst being free from pain and stress, and engaged with health services. At the end-of-life, the main well-being need was again being with loved ones and being pain free, as well as being at peace and nurturing a death experience of their choosing.

A triad of intersecting overarching themes emerged from our investigation of palliative patients’ views on their psychosocial support needs: maintaining human connections, nourishing quality of life and psychosocial coping, and optimal pain management.

Findings highlight psychosocial interventions as an essential part of a holistic approach to patient-centred care throughout the palliative care journey. Results can inform the refinement of existing psychosocial services, and the development of new interventions. Furthermore, in-person treatment delivery remains essential in an evolving digital world. Findings may also bring to us all a sharp reminder of a wise adage “live each day as if it were your last”.

Useful link

Australian Psychological Society - InPsych publication- The misunderstood world of palliative care

References:

Pakenham K, Martin CL. Psychosocial palliative care: Patients' preferred intervention medium, target domains, and well-being priorities. Palliat Support Care. 2022 Nov 15:1-9. doi: 10.1017/S1478951522001535. Epub ahead of print.

Emeritus Professor Kenneth Pakenham
Emeritus Professor of Clinical and Health Psychology
School of Psychology, Faculty of Health and Behavioural Sciences
The University of Queensland