Assessment of Distress with Physical and Psychological Symptoms of Patients in German Palliative Care Services

Abstract

Background: Within the framework of the nationwide Hospice and Palliative Care Evaluation (HOPE), the German Basic Documentation for Psycho-oncology (PO-Bado) was used from 2004 to 2006 as an optional module in most participating palliative care services to investigate how patient distress due to symptom burdens in different palliative care settings should be assessed and how professional interventions could be derived. Patients and Methods: The distress scores of 3,317 PO-Bado records out of a total of 6,958 consecutive participants from 3 yearly samples of HOPE were evaluated descriptively and compared with a reference sample of cancer patients from both general and university hospitals. Results: The relative values of distress from physical and psychological symptoms were 0.57 and 0.37 (maximum of 1.0), respectively. In 38.2% of the patients, professional psychosocial interventions were indicated. Compared to the reference sample of cancer patients, palliative care patients clearly showed more specific physical distress, but psychological symptoms were varied; in particular, distress from cognitive impairment, helplessness and grief showed higher intensities in palliative care patients than in the reference group. Conclusions: The PO-Bado rating scales assessed high levels of distress, particularly from physical symptoms, in palliative care patients. A large percentage of palliative care patients required professional psychosocial support.

Patients in palliative care—Development of a predictive model for anxiety using routine data

“…However, Kolva et al linked the influence that seems to be exerted by this variable to remaining survival time [13], which was not included in our analyses. In contrast to the findings of a previous study [28], we did not identify higher ratings of anxiety levels in specialized palliative care services than in other wards. Not surprisingly, medication with anxiolytics and antidepressants are predictors of anxiety and can also be found in the final multiple regression model described by Kolva [13].…”

Accuracy of the Distress Thermometer for home care patients with palliative care needs in Germany

“…High psychosocial distress in palliative patients has been described in the literature (Neuwohner et al, 2011; Thekkumpurath et al, 2008). Some 84% ( n = 75) of all palliative care patients who participated in our study showed clinically significant psychosocial distress as measured by the DT according to the DT ≥ 5 cutoff criterion, and 64% ( n = 57) according to the HADS total score.…”

Specific Characteristics of Patients with Advanced Genitourinary Cancer Receiving Specialized Inpatient Palliative Care

“…Our modified version contained 3 more items than the original MIDOS version (xerostomia, sleeplessness, and diarrhea). The MIDOS checklist is widely used for the basic assessment in palliative care in Germany, and has been utilized in previous studies [12][13][14][15][16][17]. 18 items relating to physical and psychosocial symptoms and problems were assessed on a 4-point Likert scale ranging from 'not present' to 'severe'.…”