Palliative Care Gaps in Providing Psychological Treatment: A Review of the Current State of Research in Multidisciplinary Palliative Care.
Elissa Kozlov, Bahar Niknejad, M C Reid
PMID 28783958WHAT IT FOUND
In 59 palliative care studies, 69.5% did not describe psychological interventions, 54.2% did not say who delivered them, and 28.9% used no psychological scale.
The evidence does not show psychosocial support reduced patient distress.
Key findings
0169.5% of articles did not provide details about the psychological component, while 8.5% described a CBT-styled intervention, 11.9% an educational intervention, and 10.2% another described intervention.
02Psychological interventions were delivered by nurses in 27.1% of studies, social workers in 3.4%, and psychologists in 3.4%, but 54.2% did not specify who delivered them and only 18.6% said the provider received training.
0342.4% of studies documented change in the expected direction, but only 13.6% of those used a mental health-specific scale, only 1.7% reported an effect size, and 28.9% used no psychological scale.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a review of published research reporting, not a direct test of whether a psychological intervention works. The included articles often did not describe the psychological intervention or who delivered it, so it is unclear what was actually provided. Measurement was inconsistent: 28.9% used no psychological scale, only 15 of 59 studies used validated mental health scales, and only 1.7% reported an effect size. Most studies used broad symptom or quality-of-life scales without reporting psychological subscale results, so changes in mood or anxiety could not be separated from other outcomes. The evidence base was mainly inpatient cancer studies, so it may not apply to outpatient care or patients with other serious illnesses. The authors note that published studies may not reflect how palliative care teams actually deliver psychological care in practice.
Declared interests
The authors declared no potential conflicts of interest.
The easy way to misread this
Do not conclude that palliative psychosocial support does not work. In 59 studies, 69.5% did not describe the psychological intervention and 28.9% used no psychological scale, so the evidence is unclear rather than negative.