title: Effects of the hospital-based palliative care team on the care for cancer patients: an evaluation study.
abstract: BACKGROUND
  The hospital-based palliative care team model has been implemented in most Western countries, but this model is new in Taiwan and there is little research to evaluate its outcomes.
  
  
  OBJECTIVE
  The purpose of this study was to evaluate the effects of the hospital-based palliative care team on the care for cancer patients.
  
  
  METHODS
  The design was a quasi-experimental study with a pretest-posttest design.
  
  
  METHODS
  A medical center, National Taiwan University Hospital in Taipei, Taiwan.
  
  
  METHODS
  Cancer patients were excluded after the hospital-based palliative care team visited if they were unable to give informed consent, were not well enough to finish the baseline assessment, were likely to die within 24h or would be discharged within 24h, or could not communicate in Mandarin or Taiwanese. A sample of 60 patients who consulted the hospital-based palliative care team was recruited.
  
  
  METHODS
  Patients recruited to the study were divided to receive the usual care only (control group, n=30) or the usual care plus visits from the hospital-based palliative care team (intervention group, n=30). Data were collected using questionnaires including the Symptom Distress Scale, Hospital Anxiety and Depression Scale, Spiritual Well-Being Scale, and Social Support Scale at the initial assessment and one week later.
  
  
  RESULTS
  Comparison between groups revealed that the degree change for edema, fatigue, dry mouth, abdominal distention, and spiritual well-being in the intervention group showed significant improvement compared to the control group (p<0.05). However, there was no difference between groups on measures of anxiety, depression and feeling of social support. Within group analysis showed patients' pain score, dyspnea, and dysphagia improved in both groups (p<0.05). In addition, the average degree of constipation and insomnia in the control group declined from baseline (p<0.05), while the degree of edema, fatigue, dry mouth, appetite loss, abdominal distention, and dizziness decreased significantly in the intervention group (p<0.05).
  
  
  CONCLUSIONS
  The findings indicated the hospital-based palliative care team can improve the care for patients in relation to symptom management and spiritual well-being. The hospital-based palliative care team is a good care model for patients and worth implementing in clinical practice in Taiwan. The results also provide a general understanding about how the hospital-based palliative care team works in Taiwanese culture.
authors.affiliation: Department of Nursing, University of Melbourne, Melbourne, Australia.
authors.forename: Chi-Yin
authors.initials: CY
authors.lastname: Kao
authors.affiliation: Department of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: weyuhu@ntu.edu.tw.
authors.forename: Wen-Yu
authors.initials: WY
authors.lastname: Hu
authors.affiliation: Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Tai-Yuan
authors.initials: TY
authors.lastname: Chiu
authors.affiliation: Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Ching-Yu
authors.initials: CY
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006779:Hospitals, Public / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D010166:Palliative Care / Q000458:organization & administration*; D010348:Patient Care Team; D013624:Taiwan
keywords: Cancer patients; Hospital-based palliative care team; Palliative care