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Monitoring of Patients’ Needs, Professional Triggers and Delivered Basic Palliative Care Interventions in Routine Inpatient and Ambulatory of Advanced Incurable Cancer Patients: : Phase I Complex Intervention Study

Franzisca Domeisen Benedetti, David Blum, Suzanne Attoun-Knobel, Mary Helen Schmidt , André Fringer & Florian Strasser

abstract Background: Evidence is increasing about effects of early
integrated specialized palliative care for cancer patients, but
few systematic work addresses the delivery of palliative care
interventions (PCI) by oncology health care professionals (OHCPs).
Aim: To develop components of a clinical practice toolbox
(CPT) for oncology professionals.
Methods: 3 Focus groups (FGs) of O-HCPs explored the if,
when, by whom and how of 7 Key PCIs (EAPC 2016).
Deductive content analysis was used for FG1 amended by
open inductive codes, between FGs peer-consensual codes
were compared and interview guide adapted. Formulated
final statements were rated by FG participants (anonymous
Delphi survey (aDS#1)) for agreement. aDS#2 presents
revised statements amended by CPT components to all
oncology professionals (37 senior oncologists / fellows, 6
leading nurses, 7 other professionals) until predefined
consensus.
Results: 19 physicians, 9 nurses, 1 psychologist par ticipated
in 3 FGs. Variability about the assessment and delivery of the agreed 7 PCIs concerned by whom (multi-professional
collaboration), how (vulnerabiity) and when (triggers). aDS#1
(16 doctors, 6 nurses, 1 psychologist) revealed agreement on:
a) all 7 PCIs are important (3 early, 2 intermediate, 2 late
phase)
b) basic communication skills are required to assess patient’s
hints for palliative needs using an individual approach,
c) oncologists and/or nurses shall primarily capture needs for
PCIs,
d) cancer disease and service utilization related triggers for
PCIs require further clarification
(2) CPT will encompass: patient booklet, screening and
monitoring sheet, structured education of oncologists.
Currently statements are reformulated to perform aDS#2 in
11.2016.
Conclusion: Oncologists, nurses and Palliative Care
specialists of a centre of integrated oncology agreed on
importance of 7 PCIs. A CPT should be pragmatic, allow
adaption to specific setting and react dynamically to
individual patient needs.
   
citation Domeisen Benedetti F, blum d, Attoun-Knobel S, Schmidt M H, Fringer A, & Strasser F (2017). Monitoring of Patients’ Needs, Professional Triggers and Delivered Basic Palliative Care Interventions in Routine Inpatient and Ambulatory of Advanced Incurable Cancer Patients:: Phase I Complex Intervention Study. In European Journal of Palliative Care (pp. 1130). Italy: European Association for Palliative Care.
   
type conference paper/poster (Deutsch)
name of conference EAPC Congress (Madrid)
date of conference 18-5-2017
title of proceedings European Journal of Palliative Care
pages 1130
publisher European Association for Palliative Care (Italy)
contact Franzisca Domeisen Benedetti