Page 180 - Hospital Authority Convention 2017

Masterclasses Masterclasses
HOSPITAL AUTHORITY CONVENTION 2017

M15.1 Lesson Learnt from the Application of Stepped Care 14:30 Room 423 & Room 424
Model for Psychosocial Service in Palliative Care

Stepped Care Psychosocial Services in Palliative Care
Kwok AOL
Department of Medicine and Geriatrics, Caritas Medical Centre, Hong Kong

World Health Organization defined palliative care as an approach to improve quality of life of patients and their families who
are facing problems associated with life-threatening illness, through the prevention and relief of suffering by means of early
identification, impeccable assessment, treatment of pain, and management of physical, psychosocial and spiritual problems.
The definition highlights the importance of psychosocial care in palliative medicine.
Since 2012, the Enhanced Psychosocial Service Programme was developed for palliative care patients and caregivers based
on the stepped care service model in palliative care unit under Hospital Authority. A psychosocial care service framework
with four different levels of care was developed with modification from the guidance of National Institute for Health and Care
(NICE) on cancer service. The four different levels of care include: Level 1 – recognition of psychosocial needs; Level 2 –
early identification of psychosocial distress; Level 3 – assessment on and intervention for distress; Level 4 – diagnosis of
psychopathology. Psychology Assistant who had received special training supervised by palliative care team will provide
psychosocial service for lower level of care (Level 2 and Level 3), while clinical psychologist will focus on higher level of care
(Level 3 and Level 4) according to the service framework.

After adoption of the stepped care model with Psychology Assistant integrated into the palliative care team, the efficiency
and effectiveness of psychosocial care were markedly improved. The coverage by clinical psychologist and total attendance
per clinical psychologist were enhanced after the programme. There were also significantly better psychological outcomes,
less depressive symptoms, increased social support, better life meaning and reduced carer inadequacy among patients,
while caregivers were with significantly less emotional distress and anxiety.

M15.2 Lesson Learnt from the Application of Stepped Care 14:30 Room 423 & Room 424
Model for Psychosocial Service in Palliative Care

Enhancing Psychosocial Care for Patients with Palliative Care Needs in the Acute Medical Wards
Chu S
Department of Medicine, Queen Elizabeth Hospital, Hong Kong
Wednesday, 17 May From acute deterioration of their organ to newly diagnosed terminal cancer, some patients will spend their last moment in
Do patients in acute medical wards have palliative care needs?

acute setting, a place usually associated with active treatment and cure. Many of these patients are in need of psychosocial
support, something often neglected in high-tech medical care nowadays. Case examples will be used to illustrate what the
situation is like in a busy medical ward. Perspectives from a non-palliative care specialist working in the acute wards will be
explored, along with sharing of some local experience as to how the situation may be improved.

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