title: The "La Caixa" Foundation and WHO Collaborating Center Spanish National Program for enhancing psychosocial and spiritual palliative care for patients with advanced diseases, and their families: preliminary findings.
abstract: OBJECTIVE
  The psycho-social needs of patients with advanced chronic illness and their families include emotional, spiritual, and bereavement care. With a funding initiative by the La Caixa Foundation and design by the WHO Collaborating Center, we developed and implemented a program for the comprehensive care of terminally-ill individuals and their families, in Spain. The intent was to improve the psycho-social and spiritual dimensions of care, to generate experience and evidence, to explore models, and to act as catalyst in the Spanish National Strategy for Palliative Care.
  
  
  METHODS
  We reviewed the process of design, implementation, and initial evaluation of the program at 18 months.
  
  
  RESULTS
  Thirty psycho-social teams' (PST) acting as support teams projects were initiated. There were 120 full-time healthcare professionals appointed (58% clinical psychologists). These professionals received training through a comprehensive postgraduate course, and all used the same documentation. Some results were collated 18 months post-implementation. The total number of patients attended to was 10,954, and the number of relatives was 17,715. The preliminary clinical outcomes show a significant improvement in well-being, and a decrease in anxiety and insomnia, although there was a smaller impact on alleviating depression. Healthcare professionals collated results on satisfaction with palliative care (PC) services.
  
  
  CONCLUSIONS
  Based on these preliminary results, we suggest that the PST can be a model of organization that is effective and efficient in improving the psycho-social and spiritual aspects of care of terminally ill patients. Further follow-up and evaluation with validated tools are the main goals for the immediate future.
authors.affiliation: The Qualy End-of-Life Observatory/WHO Collaborating Center for Palliative Care Programs, Catalan Institute of Oncology, Barcelona, Spain. xgomez.whocc@iconcologia.net
authors.forename: Xavier
authors.initials: X
authors.lastname: Gómez-Batiste
authors.forename: Montse
authors.initials: M
authors.lastname: Buisan
authors.forename: M Pau
authors.initials: MP
authors.lastname: González
authors.forename: David
authors.initials: D
authors.lastname: Velasco
authors.forename: Verónica
authors.initials: V
authors.lastname: de Pascual
authors.forename: Jose
authors.initials: J
authors.lastname: Espinosa
authors.forename: Anna
authors.initials: A
authors.lastname: Novellas
authors.forename: Marisa
authors.initials: M
authors.lastname: Martínez-Muñoz
authors.forename: Marc
authors.initials: M
authors.lastname: Simón
authors.forename: Candela
authors.initials: C
authors.lastname: Calle
authors.forename: Jaume
authors.initials: J
authors.lastname: Lanaspa
authors.forename: William
authors.initials: W
authors.lastname: Breitbart
mesh_terms: D001601:Bereavement; D005190:Family / Q000523:psychology*; D006282:Health Personnel / Q000193:education / Q000458:organization & administration; D006284:Health Plan Implementation / Q000379:methods / Q000458:organization & administration; D006801:Humans; D007391:International Cooperation; D009313:National Health Programs / Q000458:organization & administration; D020380:Needs Assessment; D010166:Palliative Care / Q000458:organization & administration*; D010348:Patient Care Team / Q000458:organization & administration; D012944:Social Support; D013030:Spain; D029181:Spirituality; D019452:Terminally Ill / Q000523:psychology*; D000078329:Workforce; D014944:World Health Organization