Assessing palliative care needs in adult patients with hematological malignancies and their caregivers: implications for referral practice.

Abstract

Background: Patients with hematological malignancies frequently experience complex physical, psychological, and spiritual concerns due to disease progression and intensive therapies. Despite these needs, palliative care services are often underutilized. This study aimed to assess the palliative care needs of adult patients with hematological malignancies and their caregivers in a tertiary care setting in India.

Methods: A descriptive survey was conducted from October 2022 to February 2023, involving 200 patients and their caregivers in oncology wards. The Needs Assessment Tool for Progressive Disease-Cancer (NAT: PD-C) was used to evaluate physical, psychological, and social needs. Data were analyzed using descriptive statistics in Jamovi 2.0.0.

Results: Of the 200 patients, 55.5% reported no unresolved physical symptoms, while 9.5% had significant concerns, including fatigue, pain, and breathlessness. Psychological distress was noted in 16% of patients, with 15.62% requiring referral to specialized services. Caregivers reported significant concerns regarding physical strain (2%) and psychological distress (14%). Only 9.55% of patients were referred to specialist palliative care services, highlighting a gap in timely palliative care access.

Conclusions: Despite a high burden of symptoms, specialist palliative care services are underutilized for patients with hematological malignancies. Early integration of palliative care can improve symptom management, reduce psychological distress, and enhance patients' and caregivers' quality of life. Training healthcare providers in palliative care principles and establishing standardized referral pathways are essential to address these unmet needs.