Mental Healthcare Delivery in Palliative Care: Patient and Caregiver Perspectives.

IF 3.5 2区 医学 Q2 CLINICAL NEUROLOGY
Mia Pattillo, Jeffers Guthrie, Molly Nowels, Maureen Ekwebelem, Karolina Sadowska, Milagros Silva, M Carrington Reid, Daniel Shalev
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Abstract

Background: Palliative care aims to improve quality of life for individuals with serious illness, yet mental health needs in this population often remain under-addressed. Currently, little is known about how patients and caregivers perceive the role of mental health services within palliative care.

Objectives: To explore patient and caregiver perspectives on (1) current delivery of mental health support in palliative care for serious medical illnesses and (2) preferences for integrated specialty mental health services.

Methods: We conducted semi-structured interviews with 23 patients receiving ambulatory palliative care and 11 caregivers at an academic medical center. Interviews explored experiences with mental health care, perceived roles of palliative care, and preferences for integration. Transcripts were analyzed using thematic analysis.

Results: Participants described strong therapeutic relationships with palliative care clinicians, who offered informal mental health support through conversations, medication management, and referrals. However, many were uncertain whether mental health care formally fell within providers' roles. Both patients and caregivers expressed broad support for integrated mental health services, citing benefits such as improved care coordination, streamlined logistics, and access to clinicians with knowledge about serious illness. Caregivers emphasized their own emotional burdens and advocated for inclusion as recipients of mental health support.

Conclusions: Patients and caregivers view integrated mental healthcare as a valuable addition to palliative care. Integration models should include specialist mental health providers, address caregiver needs, and offer flexible delivery formats. Palliative care's transdiagnostic scope, interdisciplinary structure, and psychosocial orientation make it a strategic site for integrated care.

姑息治疗中的精神卫生保健服务:患者和护理者的观点。
背景:姑息治疗旨在改善严重疾病患者的生活质量,但这一人群的心理健康需求往往未得到充分解决。目前,关于患者和护理人员如何看待精神卫生服务在姑息治疗中的作用,人们知之甚少。目的:探讨患者和护理人员对(1)目前在重症姑息治疗中提供心理健康支持的看法,以及(2)对综合专业心理健康服务的偏好。方法:我们对一家学术医疗中心接受门诊姑息治疗的23名患者和11名护理人员进行了半结构化访谈。访谈探讨了精神卫生保健的经验,姑息治疗的感知角色,以及对整合的偏好。使用主题分析对转录本进行分析。结果:参与者描述了与姑息治疗临床医生的牢固治疗关系,他们通过对话、药物管理和转诊提供非正式的心理健康支持。然而,许多人不确定精神卫生保健是否正式属于提供者的职责范围。患者和护理人员都对综合精神卫生服务表示了广泛的支持,并列举了诸如改善护理协调、简化后勤以及获得对严重疾病有了解的临床医生等好处。护理人员强调他们自己的情感负担,并主张将其纳入心理健康支持的接受者。结论:患者和护理人员认为综合精神保健是姑息治疗的一个有价值的补充。整合模式应包括专业的精神卫生提供者,解决照顾者的需求,并提供灵活的交付形式。姑息治疗的跨诊断范围、跨学科结构和社会心理取向使其成为综合护理的战略场所。
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来源期刊
CiteScore
8.90
自引率
6.40%
发文量
821
审稿时长
26 days
期刊介绍: The Journal of Pain and Symptom Management is an internationally respected, peer-reviewed journal and serves an interdisciplinary audience of professionals by providing a forum for the publication of the latest clinical research and best practices related to the relief of illness burden among patients afflicted with serious or life-threatening illness.
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