Hostname: page-component-8448b6f56d-t5pn6 Total loading time: 0 Render date: 2024-04-20T02:07:44.362Z Has data issue: false hasContentIssue false
  • English
  • Français

“Hello. May I speak with someone, please? It's not about my physical pain.”: A retrospective study about the factors associated with phone calls to a Portuguese home-based palliative care team

Published online by Cambridge University Press:  04 March 2021

Miguel Julião Open the ORCID record for Miguel Julião [Opens in a new window] ,
Bárbara Antunes Open the ORCID record for Bárbara Antunes [Opens in a new window] ,
Catarina Samorinha  and
Harvey Max Chochinov
Miguel Julião*
Affiliation:
Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Sintra, Portugal
Bárbara Antunes
Affiliation:
Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK Centro de Estudos e Investigação em Saúde da Universidade de Coimbra, Coimbra, Portugal Faculty of Medicine, University of Porto, Porto, Portugal Department of Midwifery and Palliative Care, Florence Nightingale School of Nursing, King's College London, London, UK
Catarina Samorinha
Affiliation:
Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
Harvey Max Chochinov
Affiliation:
Department of Psychiatry, Research Institute of Oncology and Hematology, Cancer Care Manitoba, University of Manitoba, Manitoba, Canada
*
Author for correspondence: Miguel Julião, Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Portugal. E-mail: migueljuliao@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

Telephone availability is integrated into our home-based palliative care team (HPCT) with the aim of helping terminally ill patients and their caregivers alleviate their physical and psychosocial suffering, in addition to the team's home visits. We aimed to compare the differences between non-callers (patients with no phone calls during the team's follow-up period) vs. callers (≥1 phone call during the team's follow-up period) across sociodemographic, clinical, physical, and psychosocial variables.

Method

Retrospective analysis of all patients with and without phone call entries registered in our anonymized database, from October 2018 to September 2020.

Results

We analyzed 389 patients: 58% were male, and the average age was 71 years old; 84% had malignancies, with a mean palliative performance status of 45%. The majority of patients (n = 281, 72%) made at least one phone call to HPCT. On average, a mean of 2.5 calls (SD = 3.61; range: 0–26) per patient was registered. Callers compared with non-callers more frequently lived with someone (p = 0.030), preferred home as a place to die (p = 0.039), had more doctor (p = 0.010) and nurse home visits (p = 0.006), a prolonged HPCT follow-up time (p = 0.053), along with more frequent emergency room visits (p < 0.001) and hospitalizations (p = 0.043). Moreover, those who made at least one phone call to the HPCT had a higher frequency of conspiracy of silence (p = 0.046), anxiety (p = 0.044), and lower palliative performance status (p = 0.001). No statistically significant associations or differences were found for the other variables.

Significance of results

Several factors seem to correlate with an increased number of phone calls, and physical suffering does not play a relevant role in triggering contacts, in contrast with psychosocial and other clinical factors.

Keywords

Home-based palliative carePhone callsRetrospective studyTerminally ill
Type
Original Article
Information
Palliative & Supportive Care , Volume 20 , Issue 1 , February 2022 , pp. 107 - 112
Check for updates
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Baird-Bower, D, Roach, J, Andrews, M, et al. (2016) Help is just a phone call away: After-hours support for palliative care patients wishing to die at home. International Journal of Palliative Nursing 22(6), 286–291.CrossRefGoogle ScholarPubMed
Bruera, E, Yennurajalingam, S, Palmer, JL, et al. (2013) Methylphenidate and/or a nursing telephone intervention for fatigue in patients with advanced cancer: A randomized, placebocontrolled, phase II trial. Journal of Clinical Oncology 31, 2421–2427.CrossRefGoogle ScholarPubMed
Centeno, C, Lynch, T, Donea, O, et al. (2013) EAPC Atlas of Palliative Care in Europe 2013, Full ed. Milan: EAPC Press.Google Scholar
Chochinov, HM, Wilson, KG, Enns, M, et al. (1995) Desire for death in the terminally ill. The American Journal of Psychiatry 152(8), 1185–1191.Google ScholarPubMed
Chochinov, HM, Wilson, KG, Enns, M, et al. (1997) “Are you depressed?” Screening for depression in the terminally ill. The American Journal of Psychiatry 154(5), 674–676.Google ScholarPubMed
Chochinov, HM, McClement, S, Hack, T, et al. (2015) Eliciting personhood within clinical practice: Effects on patients, families, and health care providers. Journal of Pain and Symptom Management 49, 974–980.CrossRefGoogle ScholarPubMed
Gammaitoni, AR, Gallagher, RM, Welz, M, et al. (2000) Palliative pharmaceutical care: A randomized, prospective study of telephone-based prescription and medication counseling services for treating chronic pain. Pain Medicine 1, 317–331.CrossRefGoogle ScholarPubMed
Gomes, B, Calanzani, N, Curiale, V, et al. (2013) Effectiveness and cost-effectiveness of home palliative care services for adults with advanced illness and their caregivers. Cochrane Database of Systematic Reviews 6, CD007760.Google Scholar
Hui, D and Bruera, E (2017) The edmonton symptom assessment system 25 years later: Past, present, and future developments. Journal of Pain and Symptom Management 7(53), 630–643.CrossRefGoogle Scholar
Julião, M, Nunes, B, Sobral, MA, et al. (2016) Is it useful to ask “Está deprimido?” (“Are you depressed?”) to terminally-ill Portuguese patients? Results from outpatient research. Palliative & Supportive Care 14(2), 138–141.CrossRefGoogle ScholarPubMed
Julião, M, Courelas, C, Costa, MJ, et al. (2018) The Portuguese versions of the This Is ME Questionnaire and the Patient Dignity Question: Tools for understanding and supporting personhood in clinical care. Annals of Palliative Medicine 7, 187–195.CrossRefGoogle ScholarPubMed
Julião, M, Sobral, MA, Calçada, P, et al. (2020) “Truly holistic?” Differences in documenting physical and psychosocial needs and hope in Portuguese palliative patients. Palliative & Supportive Care, 1–6. doi:10.1017/S1478951520000413.Google Scholar
Melin-Johansson, C, Henoch, I, Strang, S, et al. (2012) Living in the presence of death: An integrative literature review of relatives’ important existential concerns when caring for a severely ill family member. The Open Nursing Journal 6, 1–12.CrossRefGoogle ScholarPubMed
Mistiaen, P and Poot, E (2006) Telephone follow-up, initiated by a hospital-based health professional, for postdischarge problems in patients discharged from hospital to home. Cochrane Database of Systematic Reviews 2006(4), CD004510. doi:10.1002/14651858.CD004510.pub3.Google Scholar
Pais-Ribeiro, J, Silva, I, Ferreira, T, et al. (2007) Validation study of a Portuguese version of the Hospital Anxiety and Depression Scale. Psychology, Health & Medicine 12, 225–235.CrossRefGoogle ScholarPubMed
Palliative Care Needs Assessment Guidance [Internet] (2014) Place of publication: The National Clinical Programme for Palliative Care, HSE Clinical Strategy and Programmes Division [revised January 2016; cited May 2020]; [13 pages]. Available at: www.hse.ie/palliativecareprogramme.Google Scholar
Pimentel, LE, Yennurajalingam, S, Chisholm, G, et al. (2015) The frequency and factors associated with the use of a dedicated Supportive Care Center Telephone Triaging Program in patients with advanced cancer at a comprehensive cancer center. Journal of Pain and Symptom Management 49(5), 939–944.CrossRefGoogle Scholar
Sarmento, VP, Gysels, M, Higginson, IJ, et al. (2017) Home palliative care works: But how? A meta-ethnography of the experiences of patients and family caregivers. BMJ Supportive and Palliative Care 7(4), 0.CrossRefGoogle ScholarPubMed
Wilkinson, E, Salisbury, C, Bosanquet, N, et al. (1999) Patient and carer preference for, and satisfaction with, specialist models of palliative care: A systematic literature review. Palliative Medicine 13, 197–216.CrossRefGoogle ScholarPubMed
Zhou, M, Holden, L, Bedard, G, et al. (2012) The utilization of telephone follow-up in the advanced cancer population: A review of the literature. Journal of Comparative Effectiveness Research 1, 509–517.CrossRefGoogle ScholarPubMed