Kao, C.Y., Hu, W.Y., Chiu, T.Y., & Chen, C.Y. (2014). Effects of the hospital-based palliative care team on the care for cancer patients: An evaluation study. International Journal of Nursing Studies, 51(2), 226-235.

To evaluate the effects of the hospital-based palliative care team on care for patients with cancer

The hospital-based palliative care team visited intervention patients “regularly” during the one-week study period. Team members including physicians, nurses, chaplains, and social workers provided advice about medications and taught patients and families skills to relieve physical symptoms, provided emotional support, and assisted with truth-telling and preparation for death. Data were collected at baseline and one week later.

• N = 60
• MEAN AGE = 57.5 years (SD = 14.62)
• MALES: 57%, FEMALES: 43%
• KEY DISEASE CHARACTERISTICS: Patients with advanced cancer with palliative care needs
• OTHER KEY SAMPLE CHARACTERISTICS: Patients hospitalized in a medical center in Taiwan; unlikely to die or be discharged in 24 hours

• SITE: Single site
• SETTING TYPE: Inpatient   
• LOCATION: Taipei, Taiwan

• PHASE OF CARE: End-of-life care
• APPLICATIONS: Palliative care

Quasi-experimental study with a pretest-posttest design

• Symptom Distress Scale (SDS)
• Hospital Anxiety and Depression Scale (HADS)
• Spiritual Well-Being Scale
• Social Support Scale

No significant difference was seen in anxiety and depression between the control and intervention groups after one week of palliative care. Improvement was seen in edema, fatigue, dry mouth, and abdominal distention.

Nurse interventions improved symptom management for the intervention group; however, in the short timeframe of this study emotional disturbances were not affected. Cultural implications are important here; death is a taboo topic in Chinese culture, and patients' understanding of their terminal disease is low and rarely discussed.

• Small sample (< 100)
• Risk of bias (no random assignment)
• Unintended interventions or applicable interventions not described that would influence results
• Patients were given the choice of usual care plus visits from the palliative care team versus usual care alone. The timeframe was only one week, and the number of visits and disciplines of the palliative care team were not clearly described. Nurse interventions for some physical symptoms are described very generally; no interventions for depression or anxiety are described.

Palliative care consultation may benefit many symptoms of patients with cancer, but without clear interventions for depression and in this short timespan, little effect is apparent.