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Letter
To be mortal is human: professional consensus around the need for more psychology in palliative care
  1. Ursula M. Sansom-Daly1,2,3,
  2. Elizabeth A. Lobb4,5,6,
  3. Holly E. Evans1,2,
  4. Lauren J. Breen7,
  5. Anna Ugalde8,
  6. Megan Best9,10,
  7. Nienke Zomerdijk11,12,
  8. Elizabeth A. Beasley13,
  9. Keryn L. Taylor12,14,15,
  10. Josephine Clayton16,17,
  11. Louise Sharpe18,
  12. Iris Bartula19 and
  13. Ian Olver20
  14. PoCoG End of Life Care Special Interest Group
    1. 1 School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
    2. 2 Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, New South Wales, Australia
    3. 3 Sydney Youth Cancer Service, Prince of Wales Hospital, Randwick, NSW, Australia
    4. 4 IMPACCT, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
    5. 5 Palliative Care Department, Calvary Health Care Kogarah, Kogarah, New South Wales, Australia
    6. 6 School of Medicine, The University of Notre Dame, Sydney, New South Wales, Australia
    7. 7 School of Psychology, Curtin University, Perth, Western Australia, Australia
    8. 8 Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia
    9. 9 Institute for Ethics and Society, The University of Notre Dame Australia, Sydney, New South Wales, Australia
    10. 10 Department of Palliative Care, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
    11. 11 Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
    12. 12 Victorian Comprehensive Cancer Centre Alliance, Parkville, Melbourne, Victoria, Australia
    13. 13 School of Psychology, Faculty of Health and Behavioural Sciences, University of Queensland, St Lucia, Queensland, Australia
    14. 14 Psychosocial Cancer and Palliative Care, St Vincent's Hospital, Fitzroy, Melbourne, Victoria, Australia
    15. 15 Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Melbourne, Victoria, Australia
    16. 16 Centre for Learning & Research in Palliative Care, HammondCare, Greenwich Hospital, Sydney, New South Wales, Australia
    17. 17 Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
    18. 18 School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
    19. 19 Melanoma Institute Australia, The Poche Centre, North Sydney, New South Wales, Australia
    20. 20 School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
    1. Correspondence to Dr Ursula M. Sansom-Daly, Behavioural Sciences Unit, Kids Cancer Centre, Level 1 South Wing, Sydney Children's Hospital, Randwick, NSW 2031, Australia; ursula{at}unsw.edu.au

    https://doi.org/10.1136/bmjspcare-2021-002884

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      White et al 1 highlight that death and dying is everyone’s business, yet is often neglected in the training of multidisciplinary health professionals (MDHP). While physicians play a critical role in end-of-life care, patients interact with a range of health professionals. As such, it is vital that MDHP are also trained in palliative care, including end-of-life communication. Nursing and allied health professionals also spend considerable time with patients developing strong therapeutic relationships fundamental to the success of challenging conversations when adjusting to incurable illness.2 3

      Nevertheless, White et al’s survey noted considerable variability in the availability of palliative care and end-of-life-related content in UK-based undergraduate nursing and allied health courses. Only 16% of the social work courses surveyed included such training. Similarly, in Australia, 96% of MDHP perceived that their undergraduate education had underprepared them for the clinical realities of working with palliative care patients.4

      Consistent with identified gaps in the literature, White et al’s survey did not include psychologists. Psychologists are ideally placed to provide specialist end-of-life care as they are already trained in sophisticated communication skills and have the capacity to navigate challenging emotional terrain. Assisting individuals grappling with uncertainty, anxiety, grief and loss, demoralisation and hopelessness is psychologists’ ‘core business’. Further training to apply these high-level therapeutic skills to end-of-life care is critical. Vivekananda et al interviewed psychologists, many of whom had specialist end-of-life experience (21/35, …

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      Footnotes

      • Collaborators In addition to the named authors, the final group author ‘PoCoG End of Life Care Special Interest Group’ also includes Catherine Bauld, Vanessa Beesley, Pippa Blackburn, Natalie Bradford, Brenda Clasquin, Kerrie Clover, Anna Collins, Richard Egan, Baby Foo, Helen Haydon, Kate Hetherington, Sarah Heynemann, Melissa Hilson, Madeleine Juhrmann, Belinda Kiely, Madeleine King, Geraldine Largey, Fiona Maccallum, Catherine Mason, Nikki McCaffrey, Naomi McGowan, Natasha McGrath, Natasha Michael, Jan Obery, Catherine Olsson, Kim Pearce, James Penhale, Astrid Przezdziecki, Gayle Richardson, Jodie Rosenberg, Jessica Roydhouse, Mary Scott, Betty Servis, Seleena Sherwell, Evelien Spelten, Lesley Stafford, Jane Turner and Jessica Turner.

      • Contributors UMS-D developed the concept and first draft of this manuscript together with EAL and HEE. All coauthors were involved in the subsequent development, editing and refinement of the manuscript. All authors have approved the final manuscript.

      • Funding UMS-D is supported by Early Career Fellowships from the Cancer Institute New South Wales (CINSW) (ID: 2020/ECF1163) and the National Health and Medical Research Council, Australia (ID: APP1111800). UMS-D’s end-of-life communication research program is supported by grants from the HCF Research Foundation, the Adolescent and Young Adult (AYA) Cancer Global Accord and through a clinical-academic mentoring award from the Palliative Care Clinical Academic Group of the Sydney Partnership for Health, Education, Research and Enterprise. The Behavioural Science Unit is proudly supported by the Kids with Cancer Foundation and by the Kids Cancer Alliance as well as a Cancer Council New South Wales Program Grant PG16-02 with the support of the Estate of the Late Harry McPaul.

      • Competing interests None declared.

      • Provenance and peer review Not commissioned; internally peer reviewed.