The improvement of cancer patient’s insight into their disease following the intervention of the Hospital Palliative Care Team

Background: It is reported that cancer patients want as much information as possible about their diagnosis and prognosis (Jenkins et al 2001; Fallowfield et al 2002).This input regarding patient’s insight into their disease is undoubtedly a major part of providing optimal palliative care. Despite this there is little information regarding the impact of hospital based palliative care teams. The aim of this study was to assess the effect of the hospital palliative care team on cancer patient’s insight to their disease. Methodology: An evaluation study comprising a non-equivalent control group design, using a quota sample, investigated 100 cancer patients admitted to hospital for symptom control. 50 patients received hospital palliative care team intervention compared with 50 patients receiving traditional care. Outcome was assessed using the PACA assessment tool on � occasions (within 2� hours of admission/ diagnosis or referral to the team, day � and day 7) measuring the patients self reported understanding of their illness (Ellershaw et al 1995). Additionally a qualitative approach including �1 semi structured interviews with doctors and nurses to explore their perception of the palliative care team impact on cancer patient’s insight into their disease was undertaken. Results and Discussion: The results indicated that cancer patients admitted to hospital for symptom control demonstrated an improvement in their insight to their diagnosis (p<0.01). Those patients who had the additional input of the palliative care team had a greater improvement in their insight scores (between initial and final assessments) from �.98 to 2.02 (mean score), compared to the standard care group that displayed an improvement from �.86 to �.26. This input was reported by the doctors and nurses as being invaluable for the patients. Potential explanations are made for these results including the enhanced communication skills of the palliative care team are explored.