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- Title
Caring for depression in the dying is complex and challenging – survey of palliative physicians.
- Authors
Lee, Wei; Chang, Sungwon; DiGiacomo, Michelle; Draper, Brian; Agar, Meera R.; Currow, David C.
- Abstract
Background: Depression is prevalent in people with very poor prognoses (days to weeks). Clinical practices and perceptions of palliative physicians towards depression care have not been characterised in this setting. The objective of this study was to characterise current palliative clinicians' reported practices and perceptions in depression screening, assessment and management in the very poor prognosis setting. Methods: In this cross-sectional cohort study, 72 palliative physicians and 32 psychiatrists were recruited from Australian and New Zealand Society of Palliative Medicine and Royal Australian and New Zealand College of Psychiatrists between February and July 2020 using a 23-item anonymous online survey. Results: Only palliative physicians results were reported due to poor psychiatry representation. Palliative physicians perceived depression care in this setting to be complex and challenging. 40.0% reported screening for depression. All experienced uncertainty when assessing depression aetiology. Approaches to somatic symptom assessment varied. Physicians were generally less likely to intervene for depression than in the better prognosis setting. Most reported barriers to care included the perceived lack of rapidly effective therapeutic options (77.3%), concerns of patient burden and intolerance (71.2%), and the complexity in diagnostic differentiation (53.0%). 66.7% desired better collaboration between palliative care and psychiatry. Conclusions: Palliative physicians perceived depression care in patients with very poor prognoses to be complex and challenging. The lack of screening, variations in assessment approaches, and the reduced likelihood of intervening in comparison to the better prognosis setting necessitate better collaboration between palliative care and psychiatry in service delivery, training and research.
- Subjects
NEW Zealand; AUSTRALIA; DIAGNOSIS of mental depression; TERMINAL care; HEALTH services accessibility; CROSS-sectional method; MEDICAL screening; PHYSICIANS' attitudes; UNCERTAINTY; SURVEYS; MENTAL depression; QUESTIONNAIRES; INTERPROFESSIONAL relations; DESCRIPTIVE statistics; DATA analysis software; PSYCHOLOGY of physicians; PALLIATIVE treatment; LONGITUDINAL method
- Publication
BMC Palliative Care, 2022, Vol 21, Issue 1, p1
- ISSN
1472-684X
- Publication type
Article
- DOI
10.1186/s12904-022-00901-y