Effectiveness of Psychosocial Interventions in Complex Palliative Care Patients: A Quasi-Experimental, Prospective, Multicenter Study

J Palliat Med. 2018 Jun;21(6):802-808. doi: 10.1089/jpm.2017.0355. Epub 2018 Mar 13.

Abstract

Objective: To determine whether specific psychosocial interventions can ease discomfort in palliative care (PC) patients, particularly in those with high levels of pain or emotional distress.

Methods: Changes in the psychological parameters of 8333 patients were assessed in a quasi-experimental, prospective, multicenter, single group pretest/post-test study. Psychosocial care was delivered by 29 psychosocial care teams (PSTs; 137 professionals). Pre- and post-intervention changes in these variables were assessed: mood, anxiety, and emotional distress. Patients were classified as complex, when presented with high levels of anxiety, mood, suffering (or perception of time as slow), and distress (or unease, or discomfort), or noncomplex. These groups were compared to assess changes in suffering-related parameters from baseline.

Results: Psychosocial interventions reduced patients' suffering. These interventions were more effective in complex patients.

Conclusions: After successive psychosocial interventions, the level of suffering in complex patients decreased until close to parity with noncomplex patients, suggesting that patients with major complexity could benefit most from specific psychosocial treatment. These findings support the importance of assessing and treating patients' psychosocial needs.

Keywords: distress; effectiveness; palliative care; prospective studies; psychosocial intervention; suffering.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anxiety / therapy*
  • Depression / therapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Palliative Care / psychology*
  • Prospective Studies
  • Psychotherapy / methods*
  • Quality of Life / psychology*
  • Stress, Psychological / psychology*
  • Stress, Psychological / therapy*