Palliative psychological care in Germany: Results of a national online survey with psychologists and psycho-oncologists in specialist palliative care settings.

BACKGROUND

Knowledge about the structure and type of palliative psychological care is limited and heterogeneous in most countries. Due to the lack of legal regulations in Germany, it is unclear how psychologists are integrated into multiprofessional palliative care teams (MPCT).

OBJECTIVES

To describe how palliative psychology is organised in the various specialist palliative care settings for adults in Germany, how psychologists/psycho-oncologists assess their professional attitude and how satisfied they are with their work.

DESIGN

Online survey with psychologists/psycho-oncologists working in specialist palliative settings in Germany.

METHODS

The quantitative data was analysed descriptively and inferentially (correlations, group differences) using SPSS; category-based evaluation of free text comments.

RESULTS

One hundred and five of 210 respondents worked in a predominantly specialist palliative setting, mainly on palliative care units (137/210), mostly in combination with other settings (158/210), with a small proportion working in specialist palliative home care (29/210), palliative care support team within a hospital (28/210) or a hospice (16/210); the professional attitude did not differ between the predominantly and less palliative setting or the levels of professional experience. A high level of satisfaction with integration into and perceived appreciation by the MPCT, perceived effectiveness, supervision/intervision/exchange within the MPCT and overall job satisfaction was reported; when dissatisfaction was mentioned, the most common reasons given were a lack of resources, unfavourable structures or communication deficits; the predominantly palliative setting had a positive effect on satisfaction with integration into the MPCT, perceived effectiveness and overall satisfaction; a higher level of professional experience also showed a positive influence on perceived effectiveness.

CONCLUSION

Although psychologists/psycho-oncologists were present in all palliative settings, they were not regularly a core member of the MPCT. Besides structural differences in palliative psychological care, there was also heterogeneity in the qualifications of the psychologists/psycho-oncologists. These results make the structure of psychological care in palliative care facilities in Germany more transparent and could be used to promote palliative psychology expertise as an integral part of multiprofessional care.