Development of a Revised Clinical Guide to Multidimensional Needs Assessment in Palliative Care: MAP

Area of Science:

• Palliative Care Medicine
• Clinical Assessment Tools
• Healthcare Quality Improvement

Background:

• Effective needs assessment is crucial for personalized palliative care plans.
• The Multidimensional needs Assessment in Palliative care (MAP) initial encounter guide was previously developed.
• Clinical implementation challenges prompted a need for guide refinement.

Purpose of the Study:

• To refine the existing MAP clinical interview guide through expert consensus.
• To enhance the MAP guide's applicability in diverse clinical settings.
• To incorporate expert recommendations for improved palliative care needs assessment.

Main Methods:

• A two-round Delphi study involving 22 palliative care physicians.
• Consensus threshold set at 80% agreement among Delphi participants.
• Nominal group technique with 10 palliative care experts to finalize revisions.

Main Results:

• The revised MAP guide includes 48 needs, incorporating advance directives and wish to hasten death.
• Spiritual/existential concerns domain expanded to include end-of-life directives.
• Less frequent physical symptoms and complementary therapies were retained; prioritizing patient concerns is emphasized.

Conclusions:

• The updated MAP guide enhances comprehensive needs assessment in palliative care initial encounters.
• Incorporation of advance directives and end-of-life wishes strengthens the tool's utility.
• The revised MAP guide supports individualized care planning and warrants further clinical validation.