Article Text
Abstract
Introduction Values-clarification has an important role in palliative care for clinical staff and their patients (Edwards 2014). The question ‘What matters to me?’ seeks to support patients in voicing their values and forms part of the daily assessment of each patient at the Marie Curie Hospice Edinburgh.
Aims Explore staff perspectives on the role of understanding patient values and their interaction with clinical practice in a palliative care setting.
Method The current study was a service evaluation investigating the practical application of ‘What matters to me?’ as a proxy question for values identification using a retrospective casenotes review and focus group discussion with 12 clinical staff. Data was analysed using a qualitative method thematic analysis.
Results Doctors recorded ‘What matters to me?’ information most frequently (52%) and nurses second (36%). Focus group results indicated widespread understanding of the importance of values to staff personally and person-centred care but revealed varying approaches to electronic documentation. Multidisciplinary team meeting electronic records were found to be less useful than intended. Quality of evidence of community documentation of ‘What matters’ being transitioned to the inpatient setting was overall positive. Casenotes analysis gave rise to patient values core themes including family being at home and general health.
Discussion This evaluation found extensive agreement regarding the positive impact of using the ‘What matters to me?’ question to elicit patient values. Implications for hospice practice will be discussed including clarifying electronic documentation practices increased healthcare assistant access to electronic records and regular updating of the nursing handover sheets.
Reference
. Edwards AW. Therapeutic values clarification and values development for end-of-life patients: A conceptual model. American Journal of Hospice and Palliative Medicine®2014;31(4):414–419.