Symptom management by a community palliative care team

Abstract

Introduction: The Malta Hospice Movement is a community palliative care team (CPCT) established in 1989. A service evaluation was carried out to check on reduction in physical distress for patients referred to the CPCT. Method: During a period of ten weeks, all new cases referred for community palliative care services were included in the evaluation. A modified version of the Support Team Assessment Schedule (STAS) was used as a tool. The modifications done and symptoms inserted were informed by literature available on the frequency of symptoms in palliative care. The version of STAS used in this particular evaluation is available on http://www.kcl.ac.uk/schools/medicine/depts/palliative/qat/stas.html. The modified STAS was delivered at referral, and subsequently every two weeks for a total of three assessments. The STAS was delivered by the same nurse. Results: Of the 56 newly referred patients, 34 completed three assessments. The most common diagnosis was GIT cancer, while the most common reason of referral was “support”. There was a significant (1.7, p=0.039)reduction in overall mean STAS scores, with non-significant eductions in individual item scores. Males exhibited greater score reductions than females. The symptom prevalence of patients remained unaltered throughout the evaluation. Conclusions: There was reduction in physical distress for patients referred to the CPCT due to a variety of factors interacting at community level. However, symptom prevalence was unaltered. The results may be explained by the setting of care (community), lack of awareness of the present service to other stakeholders including family doctors and problems with access to relevant medications and out-of-hours cover.