Patients' needs and satisfiers: applying human scale development theory on end-of-life care.
OBJECTIVE
This review considers how needs-based care models have been recently discussed in the scientific literature and proposes the human scale development (HSD) theory to achieve high-quality care (HQC) at the end-of-life (EOL).


RESULTS
Comprehensive needs-based care models have been developed among terminally ill cancer patients focusing mostly on HQC at the EOL. To achieve this goal, the implementation of several assessment tools has triggered discussions regarding alternatives for addressing the multidimensional nature of EOL care. Uncertainty has been revealed on several research limitations such as unclear definitions, lack of knowledge of healthcare professionals, psychometric problems, patient burden and reported unmet needs. However, there is general consensus about the need to uphold EOL interventions on needs-based-holistic models in order to accomplish HQC at the EOL.


CONCLUSIONS
Patients, families and healthcare professionals become part of a process that aims to embrace a unique 'world': the patients' subjectivity, his or her own needs and resources capable of meeting those needs. During the last years, some interesting research has outlined and discussed principal broad domains that geared needs-based (patient-centered) care models; however, reported 'gaps' between desired and current practice in the provision of care reflected the complexity of human needs, specifically at the EOL. As regarding fundamental human needs, an HSD theory exists and it may contribute to improve HQC at the EOL.
Jorge
Margarita
M
Pallium Latinoamérica, Bonpland 2287, CABA, Buenos Aires, Argentina. magui1976@hotmail.com
D001118:Argentina; D006301:Health Services Needs and Demand; D006801:Humans; D008960:Models, Psychological; D009369:Neoplasms / Q000523:psychology*; D017060:Patient Satisfaction; D018802:Patient-Centered Care; D011582:Psychological Theory; D011788:Quality of Life / Q000523:psychology; D013727:Terminal Care / Q000379:methods*