Crespo Iris, Goni-Fuste Blanca, Monforte-Royo Cristina, Garcia-Salanova Aina, Rodríguez-Prat Andrea, Alonso-Babarro Alberto, Alvaro Margarita, Bavestrello Pierluigi, Belar Alazne, Bottaro David, Candelmi Diego, Casas Elisabet, Costas-Muñoz Emma, Sequeiros Claudia Cruz, de Iriarte Natalia, De Santiago Ana, Garrillo Jennifer, González-Barboteo Jesús, Ariztia Maria Jimeno, Vicuña Maria Nabal, Nitola-Mendoza Lina, Noguera-Sánchez Pablo, Rocafort Javier, Rodríguez Dulce, Sala Carme, Serna Judith, Torremorell Dolors, Balaguer Albert, Julià-Torras Joaquim
Department of Psychology, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain.
Department of Nursing, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain.
PLoS One. 2025 Jul 31;20(7):e0329354. doi: 10.1371/journal.pone.0329354. eCollection 2025.
A recent systematic review highlighted the lack of consensus on the needs that should be assessed in palliative care to develop the initial therapeutic plan. An agreed clinical interview guide for Multidimensional needs Assessment in Palliative Care (MAP) has recently been proposed.
To evaluate the feasibility of implementing the MAP guide in clinical practice.
A multicenter explanatory sequential mixed-methods feasibility study was conducted, assessing five indicators: a) acceptability to patients and family members (assessed by phone); b) participation (proportion of eligible patients assessed); c) applicability (time to administer); d) clinical utility as perceived by physicians; and e) implementation in practice. Twenty-four palliative care physicians across 10 services (outpatient, in-patient, domiciliary care) administered the MAP guide in 239 initial assessments of patients with advanced cancer. A focus group was conducted with 17 of the physicians to gather insights.
Indicators of acceptability, participation, applicability, and perceived clinical utility were fulfilled in over 90% of interviews. Implementation fell just short of the criterion (78% of needs assessed vs. 80% threshold). Patients and families provided highly positive feedback on the appropriateness of the MAP guide. Physicians found it flexible and easy to integrate into clinical practice, helping them structure the initial assessment and offer a much more comprehensive assessment of patients' needs.
The study supports the feasibility of using the MAP guide to explore palliative care needs. The MAP guide can help ensure that professionals do not overlook unmet needs, which could increase suffering and undermine quality of life.
最近一项系统评价强调，在制定姑息治疗初始治疗计划时，对于应评估哪些需求缺乏共识。最近有人提出了一份用于姑息治疗多维需求评估（MAP）的临床访谈指南。
评估在临床实践中实施MAP指南的可行性。
开展了一项多中心解释性序贯混合方法可行性研究，评估五个指标：a）患者及其家属的可接受性（通过电话评估）；b）参与度（接受评估的合格患者比例）；c）适用性（实施时间）；d）医生所感知的临床效用；e）在实践中的实施情况。来自10个服务机构（门诊、住院、居家护理）的24名姑息治疗医生在对239例晚期癌症患者的初始评估中使用了MAP指南。对其中17名医生进行了焦点小组访谈以收集见解。
超过90%的访谈满足了可接受性、参与度、适用性和感知临床效用指标。实施情况略未达到标准（评估的需求占78%，而阈值为80%）。患者及其家属对MAP指南的适用性给予了高度积极的反馈。医生们发现它灵活且易于融入临床实践，有助于他们构建初始评估并对患者需求进行更全面的评估。
该研究支持使用MAP指南探索姑息治疗需求的可行性。MAP指南有助于确保专业人员不会忽视未满足的需求，而这些需求可能会增加痛苦并损害生活质量。
