2019 Volume 14 Issue 1 Pages 15-21
This study aimed to clarify the resources required to relieve distress during palliative care delivery to cancer patients. Between April 2015 and March 2017, 1479 outpatients receiving chemotherapy for cancer were screened using the Japanese version of the Support Team Assessment Schedule (STAS-J). When the STAS-J result was 2 points and higher, the patient was considered positive for distress. A certified nurse or pharmacist performed STAS-J screening and, in cases where the patient exhibited distress, took steps to alleviate the problem themselves or consulted another resource. Distress was identified in 181 (12.2%) of the 1479 patients. These 181 patients needed 288 resources. The resources used to alleviate distress were categorized as follows: direct support by certified nurse or pharmacist (153), consultation with the attending physician (98) and other (37). The required resource included the following twelve professionals: attending physician, ophthalmologist, dermatologist, dentist, orthopedic surgeon, palliative care physician, certified nurse, certified pharmacist, medical social worker, clinical psychologist, volunteers for cancer patients, and palliative care team. The frequency of the intervention by the certified nurse or pharmacist (61, 39.9%) in directly alleviating psychiatric distress was significantly higher than by consultation with the attending physician (10, 10.2%) (p<0.0001). However, the frequency of consultation with the attending physician in alleviating physical distress (88, 89.8%) was significantly higher than that of the certified nurse or pharmacist (92, 60.1%) (p<0.0001). We conclude that the certified nurse or pharmacist is important for the delivery of palliative cancer care, because they can directly provide relief from psychiatric distress.
