20.1 (7.1) Palliative care needs assessment tools Flashcards
According to the WHO, palliative care is an approach that improves QOL of patients and families facing the problems associated with life threatening illness through the prevention and relief of suffering through by means of what three things
(1) early identification, (2) impeccable assessment and (3) treatment of pain and other problems, physical, psychological, and spiritual
What are “needs” in the context of palliative care and why are “needs assessments” important?
Needs = what an individual requires to be met in order to maintain/improve current state of well-being OR to anticipate and manage their deterioration
Important as a measure for informing clinical practice for both QOL and quality of care issues
List the six domains of palliative care according to the Canadian Hospice and Palliative Care Society. Provide an example of each
Figure 20.1.1
disease management - primary dx, secondary dx (comorbidities), prognosis, adverse events, allergies
physical needs - pain and other symptoms, LOC, cognition
psychological needs - personality, strengths, behaviour, impact of illness
social needs - cultural values, beliefs, practices, relationships
spiritual needs - meaning, value, existential, transcendental issues
practical needs - comprehensive dc planning, ADLs
end of life care - preferred place of death, advanced care planning, organ donation
loss and bereavement - loss, grief, bereavement planning and referral pathway
When using a needs assessment tool what two needs must be balanced?
obtaining the most accurate and comprehensive information possible, while minimizing the burden placed on the patient and clinician
List 3 situations where MDs may underestimate patient symptoms
low Karnofsky Performance Status,
high Mini Mental State-score
hospitalized
recently diagnosed
undergoing opioid titration
What is the most established and validated needs assessment that can be used for any chronic disease?
List one other tool that can be used for any chronic disease
POS - palliative outcome scale (the most established and well validated tool to assess needs across different patient groups)
10-item measure assesses physical, practical, family, information, and psychological problems along with quality of life in the previous 3 days, with an additional item for open-ended patient comments. It includes both patient and clinician assessment components and has been used in a variety of clinical settings, including inpatient, home, hospice, and primary care.
NEST - Needs near the end-of-life screening tool
13-item measure identifying the subjective experiences and overall care of people at the end of life
SPARC-45 Sheffield Profile for Assessment and Referral to Care
45-item multidimensional assessment tool consisting of 45 items, developed to assess the palliative and supportive care needs of malignant and non-malignant conditions across general and specialist settings, prompting referrals to palliative care services where necessary
List three brief needs assessment tools for patients with advanced cancer
Three Levels of Need Questionnaire (3LNQ)
Needs Assessment Tool for Progressive Disease-Cancer (NAT: PD-C)
Screen for Palliative and End-of-Life Care Needs in the Emergency Department (SPEED)
note: all comparatively brief measures (13–18 items) for rapid needs assessment
List three longer needs assessments for people with advanced cancer
NA-ACP - Needs Assessment of Advanced Cancer Patients
PNPC - Problems and Needs in Palliative Care
PNPC-SF - Problems and Needs in Palliative Care Short Form
List three needs assessments that can be used for any cancer patient at any point in their disease trajectory
CaNDI - Cancer Needs Distress Inventory
CARES-SF Cancer Rehabilitation Evaluation System Short Form
Palliative Care Screening Tool & NCCN Palliative Care Referral Criteria
PCM Patient Care Monitor
SCNS-SF34 Supportive Care Needs Survey Short Form
SCNS-ST9 Supportive Care Needs Survey Screening Tool
List three needs assessment tools that can be used in the setting of dementia
DCNA - John Hopkins Dementia Care Needs Assessment
CANE Camberwell Assessment of Needs for the Elderly
CareNap-D - Care Needs Assessment pack for Dementia
List one needs assessment tool for CHF and one measure of health related QOL
NAT: PD-HF - Needs Assessment Tool Progressive Disease - Heart Failure
HFNAQ - Heart Failure Needs Assessment Questionnaire
Minnesota Living with Heart Failure (MLwHF) tool, the Chronic Heart Failure Questionnaire (CHQ), and Quality of Life in Severe Heart Failure (QLQ-SHF)
What three domains are assessed by the Clinical COPD Questionnaire (CCQ) and the COPD Assessment Tool (CAT)? Which is preferred by patients?
physical symptoms, functional status, and emotional well-being
a recent study showed patients prefer the CCQ
What is the most widely used measure for needs assessment and evaluation of QOL in HIV/AIDS? What are three main advantages?
The Medical Outcomes Study HIV Health Survey (MOS-HIV) is the most widely-used measure in HIV/AIDs
Advantages: availability in numerous languages and 5-minute administration time via self-report or face-to-face and telephone interviews
A needs-based model of palliative care need to have what key components (list 3)?
◆ Accessibility to people with a life-limiting illness, irrespective of their diagnosis.
◆ Assessment of unmet needs across the spectrum of palliative care domains, systematically and repeatedly to identify changes in needs over time.
◆ Clear care pathways for addressing identified needs by the most appropriate provider or service, including generalist and specialist care providers.
◆ Continuity of care across care settings through efficient communication strategies within and between these care settings.
◆ Training of staff to support the best quality generalist and specialist palliative care to patients and their families.
◆ Rigorous evaluation of outcomes to determine the physical and psychosocial impact on patients and carers of adopting a needs-based model of palliative care, as well as the economic costs and benefits to the health-care system
Name 3 psychometric properties used to review measures of a needs assessment tool
Reliability - degree to which a measure if free from error
Validity - degree to which a measure reflects what it is supposed to measure
Responsiveness - sensitivity of a scale to detect clinical important change in an outcome over time
Acceptability - level of burden placed on those who complete the measure
Feasibility - level of burden placed on those who administer the measure
Cross-cultural adaptation
