Holistic needs assessment for hospitalized patients: A cross-sectional study

Disease affects physical, psychological, spiritual, and social well-being, underscoring the need for holistic care. This study assesses the severity of holistic needs among hospitalized patients by using the Sheffield Profile for Assessment and Referral for Care-Taiwan version (SPARC-T)-a multidimensional, self-report questionnaire.

This cross-sectional study was conducted at a medical center in Taiwan, where the SPARC-T has been implemented across various departments between January 2023 and June 2024. The severity of holistic needs among hospitalized patients was assessed across psychological, spiritual, and social domains; referral thresholds for individual domains were established through discussions among the clinical team. Furthermore, sensitivity and specificity of the SPARC-T in psychological screening using were compared with those of the Brief Symptom Rating Scale (BSRS), with psychiatric consultations used as the reference standard.

Over 17 months, 10,948 patients completed the SPARC-T, of whom 6304 valid responses were included in the analysis. These responses enabled the identification of department-specific variations in holistic needs. Notably, after exceeding domain-specific referral thresholds, 118, 207, and 111 patients directly received psychiatric, social work, and discharge planning consultations, respectively. The SPARC-T also demonstrated higher sensitivity (53.85%) than the BSRS (27.27%) and exhibited a specificity of 83.33% in detecting psychological concerns.

Holistic assessment is integral to patient care, as patients' needs vary across departments. The SPARC-T effectively identifies patients requiring support and exhibits excellent sensitivity in detecting holistic needs, it is a valuable tool for hospital-wide holistic screening and can be integrated into comprehensive care settings.

Addressing inpatients' physical, psychological, spiritual and social needs is essential for providing holistic care. This study indicated that SPARC-T questionnaire effectively identified department-specific patient needs. Moreover, the SPARC-T questionnaire exhibited greater sensitivity in evaluating psychological needs than did the BSRS-5. This study highlights the department-specific variations in patients' holistic needs and can help clinicians provide targeted support.