Self-rating makes the difference: identifying palliative care needs of patients feeling severely affected by multiple sclerosis.
OBJECTIVE
People feeling severely affected by multiple sclerosis (MS) comprise a heterogeneous group, and this heterogeneity leads to very distinct needs and makes planning for needs difficult. To provide optimal care, it is important to identify specific needs in specific subgroups. Our objective was to identify the specific palliative care (PC) needs of patients who felt severely affected by the disease by analyzing their feeling (1) more or (2) less severely affected and their possible differences in expressed care needs.


METHODS
A self-report questionnaire with 25 needs categories including 7 categories pertaining to care was applied to patients who felt severely affected by MS. An additional single question identified patients feeling more (≥7, median-split) and less (<7) severely affected. Differences were analyzed by chi-squared and Mann-Whitney U tests. The sample (N = 573) was composed of respondents who replied to an invitation by the German Multiple Sclerosis Society to participate in a survey on unmet needs of severely affected patients.


RESULTS
Of 573 patients (median age 51), 358 (62.48%) felt more severely affected. Compared to patients feeling less severely affected, they found the stress on their next of kin to be higher (p < 0.001), were in greater need of home visitation (p < 0.001), did not have permanent neurologists (p = 0.016), and felt that they visited them too rarely (p < 0.0001). They also needed more emotional support from their nursing care service (p = 0.006).


CONCLUSIONS
A self-rating scale can identify two groups of patients with different care needs. These data may help shaping patient-centered support structures. Palliative care, with its multidisciplinary approach, might be one further option to meet the specific needs of patients and their relatives.
Department of Palliative Medicine,University Hospital of Cologne,Cologne,Germany.
Julia
http://orcid.org/0000-0003-3135-2693
J
Strupp
Department of Palliative Medicine,University Hospital of Cologne,Cologne,Germany.
Heidrun
H
Golla
Department of Palliative Medicine,University Hospital of Cologne,Cologne,Germany.
Maren
M
Galushko
Department of Palliative Medicine,University Hospital of Cologne,Cologne,Germany.
Raphael
R
Buecken
Center for Health Services Research,University of Cologne,Cologne,Germany.
Nicole
N
Ernstmann
Institute of Medical Statistics,Informatics and Epidemiology,University Hospital of Cologne,Cologne,Germany.
Moritz
M
Hahn
Center for Health Services Research,University of Cologne,Cologne,Germany.
Holger
H
Pfaff
Department of Palliative Medicine,University Hospital of Cologne,Cologne,Germany.
Raymond
R
Voltz
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000628:therapy*; D020380:Needs Assessment; D010166:Palliative Care / Q000379:methods* / Q000523:psychology; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
Multiple sclerosis; Needs assessment; Palliative care; Severe affectedness