Quality Indicators in Psychological Care for Patients With Serious Illness: A Systematic Review

Psychological care for patients with serious illness is recommended; however, established quality indicators for this care are lacking.

This study aimed to review clinical quality indicators to evaluate the quality of psychological care for patients with serious illnesses.

This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched 6 databases, including MEDLINE, EMBASE, and PsycINFO. Our review included studies on the development of quality indicators for psychological care in patients with serious illness. Study selection and data extraction were conducted independently, and methodological quality was evaluated using the Appraisal of Indicators through Research and Evaluation instrument. The study protocol was registered with the University Hospital Medical Information Network (UMIN000051290).

Among the identified 2119 reports, 345 reports were reviewed in detail and 12 studies met the eligibility criteria. From these, 24 quality indicators were identified, some of which overlapped conceptually or in content: 1 structure, 14 process, and 9 outcome indicators. According to the Appraisal of Indicators through Research and Evaluation instrument, most studies satisfied the category 1 criteria (clarity of purpose, relevance, and organizational context); however, formal validation of the developed indicators in practice was rarely conducted.

There is an urgent need for a comprehensive set of validated quality indicators to assess the quality of psychological care across multiple components. Increasing the incorporation of evidence-based psychological care practices for patients with serious illnesses would support the development of valid and useful clinical quality indicators.