Patient Needs and Palliative Care Psychosocial Interventions Among a Primarily Hispanic Hepatology Clinic Population at a Large Public Hospital: A Qualitative Chart Review

Abstract

Background and Aims:

Advanced liver disease is the ninth leading cause of death in the United States and the seventh leading cause of death among Hispanic individuals. This study aimed to identify the needs of a predominantly Hispanic patient population with advanced liver disease and the social work interventions provided as part of a palliative care team intervention integrated within a hepatology clinic at a large urban public hospital.

Methods:

We conducted a retrospective qualitative analysis of palliative care social work medical record entries from a palliative care intervention embedded in a hepatology clinic in the United States. The palliative care social worker was the primary person responsible for the provision of follow-up and case management of patients. Using content analysis, three researchers coded the data; two members of the research team each coded half of the patient records, while the third researcher coded all patient records. Researchers met to reconcile codes and identify themes.

Results:

Patient stressors included physical symptoms, financial hardship, and challenges related to immigration status. Palliative care psychosocial interventions included psychosocial counseling, end-of-life care planning, social service referrals, substance use support, and help navigating the health care system.

Conclusions:

Findings illustrate the complex interplay between social determinants of health and disease management for Hispanic patients with advanced liver disease as well as the role of palliative care in providing tailored psychosocial and medical support.