TY - JOUR
T1 - Development and Use of the 'SENS'-Structure to Proactively Identify Care Needs in Early Palliative Care-An Innovative Approach
AU - Fliedner, Monica C.
AU - Mitchell, Geoffrey
AU - Bueche, Daniel
AU - Mettler, Monika
AU - Schols, Jos M. G. A.
AU - Eychmueller, Steffen
N1 - Funding Information:
The authors wish to thank patients and families for their openness in ePC conversations, which enabled us to develop the ‘SENS’-structure. Also, we would like to thank all clinicians for their valuable feedback in the development process. A special thanks to Sofia Zambrano and Nora Lüthi who helped us by editing the article.
Publisher Copyright:
© 2019 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2019/2/20
Y1 - 2019/2/20
N2 - Anticipatory planning for end of life requires a common language for discussion among patients, families, and professionals. Studies show that early Palliative Care (PC) interventions based on a problem-oriented approach can improve quality of life, support decision-making, and optimize the timing of medical treatment and transition to hospice services. The aim of this quality-improvement project was to develop a pragmatic structure meeting all clinical settings and populations needs. Based on the Medical Research Council (MRC) framework, a literature review identifying approaches commonly used in PC was performed. In addition, more than 500 hospital-based interprofessional consultations were analyzed. Identified themes were structured and compared to published approaches. We evaluated the clinical usefulness of this structure with an online survey among professionals. The emerged 'SENS'-structure stands for: Symptoms patients suffer from; End-of-life decisions; Network around the patient delivering care; and Support for the carer. Evaluation among professionals has confirmed that the 'SENS'-structure covers all relevant areas for anticipatory planning in PC. 'SENS' is useful in guiding patient-centered PC conversations and pragmatic anticipatory planning, alongside the regular diagnosis-triggered approach in various settings. Following this approach, 'SENS' may facilitate systematic integration of PC in clinical practice. Depending on clearly defined outcomes, this needs to be confirmed by future randomized controlled studies.
AB - Anticipatory planning for end of life requires a common language for discussion among patients, families, and professionals. Studies show that early Palliative Care (PC) interventions based on a problem-oriented approach can improve quality of life, support decision-making, and optimize the timing of medical treatment and transition to hospice services. The aim of this quality-improvement project was to develop a pragmatic structure meeting all clinical settings and populations needs. Based on the Medical Research Council (MRC) framework, a literature review identifying approaches commonly used in PC was performed. In addition, more than 500 hospital-based interprofessional consultations were analyzed. Identified themes were structured and compared to published approaches. We evaluated the clinical usefulness of this structure with an online survey among professionals. The emerged 'SENS'-structure stands for: Symptoms patients suffer from; End-of-life decisions; Network around the patient delivering care; and Support for the carer. Evaluation among professionals has confirmed that the 'SENS'-structure covers all relevant areas for anticipatory planning in PC. 'SENS' is useful in guiding patient-centered PC conversations and pragmatic anticipatory planning, alongside the regular diagnosis-triggered approach in various settings. Following this approach, 'SENS' may facilitate systematic integration of PC in clinical practice. Depending on clearly defined outcomes, this needs to be confirmed by future randomized controlled studies.
KW - chronic life-limiting condition
KW - palliative care
KW - patient-centered care
KW - early palliative care intervention
KW - advance care planning
KW - needs assessment
KW - GOLD STANDARDS FRAMEWORK
KW - OF-LIFE
KW - GENERAL-PRACTICE
KW - CANCER
KW - COST
U2 - 10.3390/healthcare7010032
DO - 10.3390/healthcare7010032
M3 - Article
C2 - 30791565
SN - 2227-9032
VL - 7
JO - Healthcare
JF - Healthcare
IS - 1
M1 - 32
ER -