What do healthcare providers require to discuss patients’ social and spiritual needs with help of the Utrecht Symptom Diary - 4 Dimensional?

Background/aims: Palliative care attends to one’s the physical, psychological, social and spiritual dimension. The Utrecht Symptom Diary - 4 Dimensional (USD-4D) has been developed as a conversation tool and contains items covering all four dimensions. A feasibility study on the USD-4D has shown that healthcare providers are less inclined to converse about the social and spiritual dimensions than they are to discuss the physical and psychological dimensions. Therefore, we want to explore what healthcare providers require to discuss patients’ social and spiritual needs when using the USD-4D .
Methods: A mixed-methods study with a sequential explanatory design was conducted from August to November 2019. In the first phase, quantitative data was collected through a survey among healthcare providers and organizations (n = 200) that work with the USD-4D. The survey was based on an explorative meeting with healthcare providers who work with the USD-4D. In the second phase, focus group interviews were conducted with 7 care providers per focus group, reflecting on the significance of the results of the survey.
Results: An interim analysis (n=100) showed that care providers require both intrinsic support and extrinsic motivation in both personal and professional areas. Intrinsic support relates to personal motivation, self-confidence and peace of mind to make the social and spiritual dimension of patients discussable. Extrinsic motivation involves support in understanding and explaining the USD-4D and its organizational embedding.
Conclusions: Healthcare providers indicate that the USD-4D is helpful in daily practice for discussing social and spiritual needs. They often, however, do not see themselves as adequately equipped to address the social and spiritual dimensions. More support is needed in order to establish confidence in delivering social and spiritual care. Also, more research should focus on what healthcare professionals require to deliver appropriate, patient-tailored care. Funding: ZonMw