Screening for Intimacy Concerns in a Palliative Care Population: Findings from a Pilot Study

Intimacy is an important component of the palliative care (PC) assessment. Evaluation of patient concerns related to intimacy should be included in a comprehensive PC consultation. The concerns are rarely assessed for hospitalized PC patients, yet there is evidence to support that patients want to talk about intimacy.

We wanted to understand (1) if intimacy was an important issue for hospitalized PC patients; (2) how intimacy was impacted by illness; and, (3) if intimacy concerns were present, what those concerns involved.

We designed a brief screening tool to administer to adult patients receiving PC consultation at two hospitals. The tool included demographic information, relevant medical diagnoses, two questions to help identify intimacy issues, and PC team communication to the referring medical team. Mean screening tool administration time was eight minutes.

Although the vast majority (96%) of patients reported that they had not been asked about intimacy concerns before the PC consult, a slight majority (56.2%) reported that illness had either significantly or moderately impacted intimacy. Most (96%) found the intimacy discussion helpful and wanted to discuss these issues with medical providers. Those at end of life (EOL) (died <3 months of PC consultation) were older (M = 65 years; standard deviation [SD] = 9.4) than those who were not (55 years; SD = 15.4; p = 0.004). A majority (70.5%) at EOL indicated their illness significantly or moderately impacted their intimacy, and all reported the conversation was helpful and wanted to discuss the issue with providers.

Pilot data from this quality improvement (QI) project suggest a clear need for intimacy assessment in PC consultation. Intimacy is impacted by serious illness and patients/partners want to discuss issues with clinicians. PC clinicians can incorporate intimacy discussions as part of a routine assessment without adding significant amount of time.