title: "What bothers you the most?" Initial responses from patients receiving palliative care consultation.
abstract: The purpose of this investigation is to describe how hospitalized palliative care patients respond to the question "What bothers you the most?" at the time of initial consultation. A retrospective descriptive content analysis of first person responses routinely recorded during initial interview (n = 286) was carried out. Responses were grouped in 7 major categories: physical distress (44%); emotional, spiritual, existential, or nonspecific distress (16%); relationships (15%); concerns about the dying process and death (15%); loss of function and normalcy (12%); distress about location (11%); and distress with medical providers or treatment (9%). Fifteen percent of responses were unable to be reliably categorized. Although many of our patients were not able to answer open-ended questions because of illness, those who did shared a wide range of concerns that provided a starting point for clinical prioritization. Further research into the use of such simple questions at time of initial consultation is warranted.
authors.affiliation: Center for Ethics, Humanities, and Palliative Care, University of Rochester Medical Center, Rochester, New York 146142, USA. mindy_shah@urmc.rochester.edu
authors.forename: Mindy
authors.initials: M
authors.lastname: Shah
authors.forename: Timothy
authors.initials: T
authors.lastname: Quill
authors.forename: Sally
authors.initials: S
authors.lastname: Norton
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Sada
authors.forename: Marcia
authors.initials: M
authors.lastname: Buckley
authors.forename: Charlotte
authors.initials: C
authors.lastname: Fridd
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D001293:Attitude to Death; D001294:Attitude to Health; D004644:Emotions; D005086:Existentialism / Q000523:psychology; D005190:Family / Q000523:psychology; D005239:Fear / Q000523:psychology; D005260:Female; D006117:Grief; D006301:Health Services Needs and Demand; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D009518:New York; D015404:Nursing Methodology Research; D010166:Palliative Care / Q000523:psychology*; D012017:Referral and Consultation; D012189:Retrospective Studies; D029181:Spirituality; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D019452:Terminally Ill / Q000523:psychology*