Work

Implementation of the psycho-existential symptom assessment scale in palliative care: Qualitative analysis of stakeholders perspectives

Year: 2024

Type: article

Abstract: To explore 1) perspectives of feasibility, acceptability, integration and sustainability of the Psycho-existential Symptom Assessment Scale (PeSAS); 2) barriers and benefits of PeSAS in its real-world performance; and 3) clinician confidence and perceived competency in using PeSAS. Thirty-one key stakeholders from nine palliative care services who participated in the implementation of the PeSAS were purposefully sampled and participated in semi-structured interviews. Data was managed using the Determinants Framework. Benefits of PeSAS were a common language enhancing communication, identifying symptoms of psycho-existential distress, initiating referral, providing acknowledgement for previously unrecognised distress and enhancing patient agency. Key barriers were the availability of skilled clinicians, patient characteristics such as delirium and phase of illness, avoidance of confronting end-of-life conversations, information technology resourcing, and reduced engagement due to language, culture and health literacy. Screening using the PeSAS is feasible and acceptable once clinicians are adequately trained to administer it. Our study highlights the benefits of qualitative enquiry in developing and implementing new interventions. The identification and management of psycho-existential symptoms should be part of routine practice in palliative care. However, adequate staff training, resourcing, referral pathways and implementation process and outcome assessments are important to ensure sustainability. • Routine screening of psycho-existential symptoms using the PeSAS is feasible and acceptable across palliative care services. • Integration of the PeSAS in the clinical setting requires personal, infrastructure, time and normalisation into routine practice. • The PeSAS enables communication but its use may be impeded by language, cultural issues and the sensitivity of the enquiry. • Training is essential to sustain confidence when exploring and responding to psycho-existential distress.

Source: Patient Education and Counseling

DOI: 10.1016/j.pec.2024.108419

Authors: Natasha Michael, Gaye Moore, Jane Appleton, David Kissane

Institutions: Monash University, The University of Melbourne, St Vincent's Hospital Sydney

Language: English

Topic: Palliative Care and End-of-Life Issues

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,350