Anxiety, depression and psychosocial needs are the most frequent concerns reported by patients: preliminary results of a
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PSYCHIATRY AND PRECLINICAL PSYCHIATRIC STUDIES - ORIGINAL ARTICLE
Anxiety, depression and psychosocial needs are the most frequent concerns reported by patients: preliminary results of a comparative explorative analysis of two hospital‑based palliative care teams in Germany and Japan Birgitt van Oorschot1 · Koji Ishii2 · Yuko Kusomoto2 · Lea Overbeck1 · Theresa Zetzl1 · Carmen Roch1 · Andreas Mettenleiter3 · Hiroko Ozawa4 · Michael Flentje1 Received: 28 January 2020 / Accepted: 30 March 2020 © The Author(s) 2020
Abstract In the partnership between the medical departments of Würzburg University, Germany, and Nagasaki University, Japan, palliative care is a relevant topic. The aim of the study was to perform a comparative analysis of the hospital-based palliative care teams in Würzburg (PCT-W) and Nagasaki (PCT-N). Survey of staff composition and retrospective analysis of PCT patient charts in both PCTs were conducted. Patients self-assessed their symptoms in PCT-W and in Radiation Oncology Würzburg (RO-W). The (negative) quality indicator ‘percentage of deceased hospitalised patients with PCT contact for less than 3 days before death’ (Earle in Int J Qual Health Care 17(6):505–509, 2005) was analysed. Both PCTs follow a multidisciplinary team approach. PCT-N saw 410 cancer patients versus 853 patients for PCT-W (22.8% non-cancer patients). The Eastern Cooperative Oncology Group Performance Status at first contact with PCT-N was 3 or 4 in 39.3% of patients versus 79.0% for PCT-W. PCT-N was engaged in co-management longer than PCT-W (mean 20.7 days, range 1–102 versus mean 4.9 days, range 1–48). The most frequent patient-reported psychological symptom was anxiety (family anxiety: 98.3% PCT-W and 88.7% RO-W, anxiety 97.9% PCT-W and 85.9% RO-W), followed by depression (98.2% PCT-W and 80.3% RO-W). In 14 of the 148 deceased patients, PCT-N contact was initiated less than 3 days before death (9.4%) versus 121 of the 729 deceased PCT-W patients (16.6%). Psychological needs are highly relevant in both Germany and Japan, with more than 85% anxiety and depression in patients in the Japanese IPOS validation study (Sakurai in Jpn J Clin Oncol 49(3):257–262, 2019). This should be taken into account when implementing PCTs. Keywords Hospital-based palliative care · Patient-reported outcome · Quaility indicator · Anxiety · Depression
Introduction
* Birgitt van Oorschot [email protected] 1
Interdisciplinary Centre Palliative Care, Department of Radiation Oncology, University Hospital Würzburg, Würzburg, Germany
2
Palliative Care Team, University Hospital Nagasaki, Nagasaki, Japan
3
Institute of the History of Medicine, University of Würzburg, Würzburg, Germany
4
Department of Neuropsychiatry, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
As part of joint research activities between the medical departments of Nagasaki University and Würzburg University that started in 2011, our focus was set on palliative care. In the spirit and tradition of the famous Würzburgborn physician and Ja
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