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Effects of a primary palliative care intervention on quality of life and mental health in cystic fibrosis
Author(s) -
Friedman Deborah,
Linnemann Rachel W.,
Altstein Lily L.,
Georgiopoulos Anna M.,
Islam Suhayla,
Bach KieuTram,
John Anita,
Fracchia M. Shan,
Neuringer Isabel,
Lapey Allen,
Sicilian Leonard,
Moskowitz Samuel M.,
Yonker Lael M.
Publication year - 2019
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.24311
Subject(s) - medicine , mental health , referral , palliative care , quality of life (healthcare) , psychological intervention , coping (psychology) , distress , disease , intervention (counseling) , family medicine , psychiatry , nursing , clinical psychology
Background Despite the significant impact of chronic symptoms on quality of life with cystic fibrosis (CF), the role of palliative care in management of this disease is not well defined. The coping, goal assessment, and relief from evolving CF symptoms (CF‐CARES) model is a primary palliative care intervention designed to provide chronic symptom management at all stages of the disease. The goal of this pilot study was to estimate the effectiveness of the CF‐CARES intervention on improving chronic symptoms and quality of life for people living with CF. Methods A structured assessment was used to guide referral to supportive services intended to address burdensome symptoms. Follow‐up assessments were performed approximately 3 and 6 months later. Longitudinal regression analyses of changes in symptoms and quality of life were performed for all participants regardless of utilization of supportive services. Subgroup analyses were performed for subjects participating in mental health and alternative health services. Results Forty‐one subjects completed assessment and referral processes. The mean number of CF‐associated symptoms decreased over time, as did respiratory symptom‐related distress and depressive symptoms. Subjects utilizing alternative health services reported less psychological distress at follow‐up. Among subjects with severe disease, mental health, and quality of life improved, especially for those using mental health services. Conclusions The CF‐CARES model resulted in significant mental health and quality‐of‐life benefits, suggesting the value of integrating symptom management interventions into routine CF care. Moreover, mental health services can play a key role in CF‐specific primary palliative care, especially for those with advanced disease.