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Development and Use of the ‘SENS’-Structure to Proactively Identify Care Needs in Early Palliative Care—An Innovative Approach

1
University Centre for Palliative Care, University Hospital Bern, 3010 Bern, Switzerland
2
Department of Health Services Research, School CAPHRI (Care and Public Health Research Institute), Maastricht University, Duboisdomein 30, 6229 GT Maastricht, The Netherlands
3
Primary Care Clinical Unit, Faculty of Medicine, University of Queensland, Brisbane 4072, Australia
4
Centre for Palliative Care, Kantonsspital St.Gallen, CH-9007 St.Gallen, Switzerland
*
Author to whom correspondence should be addressed.
Healthcare 2019, 7(1), 32; https://doi.org/10.3390/healthcare7010032
Received: 9 December 2018 / Revised: 20 January 2019 / Accepted: 15 February 2019 / Published: 20 February 2019
(This article belongs to the Special Issue Recent Advances in Palliative Care)
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Abstract

Anticipatory planning for end of life requires a common language for discussion among patients, families, and professionals. Studies show that early Palliative Care (PC) interventions based on a problem-oriented approach can improve quality of life, support decision-making, and optimize the timing of medical treatment and transition to hospice services. The aim of this quality-improvement project was to develop a pragmatic structure meeting all clinical settings and populations needs. Based on the Medical Research Council (MRC) framework, a literature review identifying approaches commonly used in PC was performed. In addition, more than 500 hospital-based interprofessional consultations were analyzed. Identified themes were structured and compared to published approaches. We evaluated the clinical usefulness of this structure with an online survey among professionals. The emerged ‘SENS’-structure stands for: Symptoms patients suffer from; End-of-life decisions; Network around the patient delivering care; and Support for the carer. Evaluation among professionals has confirmed that the ‘SENS’-structure covers all relevant areas for anticipatory planning in PC. ‘SENS’ is useful in guiding patient-centered PC conversations and pragmatic anticipatory planning, alongside the regular diagnosis-triggered approach in various settings. Following this approach, ‘SENS’ may facilitate systematic integration of PC in clinical practice. Depending on clearly defined outcomes, this needs to be confirmed by future randomized controlled studies. View Full-Text
Keywords: chronic life-limiting condition; palliative care; patient-centered care; early palliative care intervention; advance care planning; needs assessment chronic life-limiting condition; palliative care; patient-centered care; early palliative care intervention; advance care planning; needs assessment
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MDPI and ACS Style

Fliedner, M.C.; Mitchell, G.; Bueche, D.; Mettler, M.; Schols, J.M.G.A.; Eychmueller, S. Development and Use of the ‘SENS’-Structure to Proactively Identify Care Needs in Early Palliative Care—An Innovative Approach. Healthcare 2019, 7, 32.

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