Characteristics and Outcomes of Psychology Referrals in a Palliative Care Department

Sujin Ann-Yi, Eduardo Bruera, Jimin Wu, Diane D. Liu, Monica Agosta, Janet L. Williams, Vishidha Reddy Balankari, Cindy L. Carmack

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

Context: Psychologists can provide unique contributions to interdisciplinary palliative care. Despite research indicating high distress in palliative care cancer patients, little has been reported regarding the feasibility and practice of psychology in this setting. Objectives: To review the integration of clinical psychology practice in a palliative care department at a major comprehensive cancer center. Methods: Retrospective chart review of 1940 unique cancer patients (6451 total patient contacts) referred for psychology services provided by clinical psychologists in palliative care from September 1, 2013 to February 29, 2016. Results: Psychologists provided services to 1644 inpatients (24% of palliative care inpatients) and 296 outpatients (19% of palliative care outpatients). Most of them (85%) received services in the inpatient setting. Most patients were females (57%) and white (68%) with a variety of cancer diagnoses. Adjustment disorders were the most prevalent in both settings with significant differences in other Diagnostic and Statistical Manual of Mental Disorders (5th Edition) diagnoses by service location (P < 0.0001). Psychological assessment (86%) and supportive expressive counseling (79%) were the most frequent services provided in the initial consult. Duration of initial visit was significantly longer in outpatient (median 60 minutes) compared with inpatient setting (median 40 minutes) (P < 0.0001). No significant differences were noted between settings regarding the median number of counseling sessions per patient; however, most (70%) only received one or two sessions. Over time, total patient encounters increased in the inpatient setting (P < 0.0001), whereas session lengths in both settings significantly decreased (P < 0.0001). Conclusion: Palliative care psychology services successfully integrated into an interdisciplinary palliative care department and rapidly grew in both inpatient and outpatient settings.

Original languageEnglish (US)
Pages (from-to)344-351
Number of pages8
JournalJournal of pain and symptom management
Volume56
Issue number3
DOIs
StatePublished - Sep 2018

Keywords

  • Palliative care psychology
  • health psychology
  • palliative care medicine
  • palliative medicine
  • psycho-oncology
  • retrospective study

ASJC Scopus subject areas

  • General Nursing
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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