title: Consultation in palliative care: the relevance of clarification of problems.
abstract: This study aims to determine the extent and nature of problems in palliative care that are newly identified in the consultation process and the factors influencing their identification. The consultation process includes clarification of problems mentioned by professionals requesting advice. Data are derived from the standard registration forms of Palliative Care Consultation teams. Multilevel logistic regression analysis was carried out with newly identified problem as dependent variable. Fifty seven percent of problems (n=7854) were newly identified. Most newly identified problems were related to physical and pharmacological problems. If psychosocial/spiritual problems were identified, this occurred in most cases through clarification (70%). Newly identified problems were more likely to be identified in the domain of spiritual and psychosocial problems, in bedside consultations, in requests from clinical physicians, and for patients accommodated in a hospice or hospital. Explicit clarification of problems facilitates the identification and addressing of a more comprehensive and specific scope of problems.
authors.affiliation: Centre for Quality of Care Research (WOK) and Vocational Training General Practitioners, 117 Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. M.Vernooy-Dassen@voha.umcn.nl
authors.forename: Myrra J F J
authors.initials: MJ
authors.lastname: Vernooij-Dassen
authors.forename: Marieke M
authors.initials: MM
authors.lastname: Groot
authors.forename: Josien
authors.initials: J
authors.lastname: van den Berg
authors.forename: Annemieke
authors.initials: A
authors.lastname: Kuin
authors.forename: Barbara A
authors.initials: BA
authors.lastname: van der Linden
authors.forename: Lia
authors.initials: L
authors.lastname: van Zuylen
authors.forename: Ben J P
authors.initials: BJ
authors.lastname: Crul
authors.forename: Richard P T M
authors.initials: RP
authors.lastname: Grol
mesh_terms: D000328:Adult; D000368:Aged; D017051:Hospice Care; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000517:prevention & control; D010166:Palliative Care / Q000592:standards*; D010348:Patient Care Team / Q000592:standards; D019095:Point-of-Care Systems; D011446:Prospective Studies; D012017:Referral and Consultation; D029181:Spirituality