title: Clinical evaluation of theMood and Symptom Questionnaire (MSQ) in a day therapy unit in a palliative support centre in the United Kingdom.
abstract: OBJECTIVE
  To evaluate the use of the Mood and Symptom Questionnaire (MSQ) within a program of structured psychosocial interventions in a Supportive and Palliative Care Center. Palliative care patients have a range of psychological symptoms as well as physical symptoms. Considerable expertise in controlling pain and fear of pain, other physical symptoms, and psychosocial distress has been built up in hospices and palliative care units. This expertise can be used even at late stages in the patient's illness to improve quality of life.
  
  
  METHODS
  We evaluated the usefulness of the MSQ to record patient responses, as an aid to patient/staff discussions, and as a staff-training tool. The questionnaire consisted of visual analog scales completed by the patient with a staff member present. Using the tool increased the opportunities for staff and patients to discuss problematic psychosocial issues. Where possible, we obtained data at two time points and compared the responses.
  
  
  RESULTS
  The MSQ was rapidly accepted as a clinical tool in the day therapy setting by staff and the patients. The process of completing the questionnaire encouraged patients to face and discuss difficult issues. Discussion of the issues raised on the questionnaire had a wider effect, influencing interactions and communications through the unit and facilitating wider discussion of other nonpain symptoms. The medical psychotherapist associated with the unit used the MSQ responses as a training tool to increase staff awareness and knowledge and understanding of psychological issues related to the patients' total pain experience by discussing the questionnaires with them.
  
  
  CONCLUSIONS
  The use of this tool helped to identify some psychological issues that proved relatively straightforward to address once uncovered. Patients benefited from this opportunity when their remaining time was relatively short. Their quality of life at the end of their lives was improved.
authors.affiliation: Arthur Rank Hospice, Brookfields Hospital, Cambridge, United Kingdom. ecc22@cam.ac.uk
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Chapman
authors.forename: Judith
authors.initials: J
authors.lastname: Whale
authors.forename: Annette
authors.initials: A
authors.lastname: Landy
authors.forename: David
authors.initials: D
authors.lastname: Hughes
authors.forename: Margaret
authors.initials: M
authors.lastname: Saunders
mesh_terms: D000223:Adaptation, Psychological; D001293:Attitude to Death; D017051:Hospice Care / Q000379:methods / Q000523:psychology; D006801:Humans; D019964:Mood Disorders / Q000175:diagnosis* / Q000523:psychology; D010146:Pain / Q000523:psychology; D059408:Pain Management; D010166:Palliative Care / Q000379:methods* / Q000523:psychology / Q000592:standards; D010555:Personality Inventory; D011369:Professional-Patient Relations; D011594:Psychometrics / Q000379:methods*; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D006113:United Kingdom