Evaluation of palliative care patients with different scales in the emergency department and the importance of home healthcare

Introduction
With this comprehensive study, we aimed to contribute to the integration process of palliative care (PC) to emergency departments (ED) by determining ED patients needing PC, with the help of a new screening method and assessment with the Screen for Palliative and End-of-Life Care Needs in the emergency department (SPEED), Karnofsky performance scale (KPS), and Edmonton Symptom Assessment Scale (ESAS).

Material and methods
Patients who were admitted to the ED between 2015 and 2017 were included in this prospective study. The study form included the following variables: demographic information, duration of diagnosis, PC follow-up, consultation status, and the outcome in ED. SPEED, KPS, and ESAS were applied to the patients.

Results
The study was carried out with the participation of 150 patients. The mean score of the patients on the KPS was 43.13. The most common symptoms observed in patients were fatigue, pain, anorexia, and nausea, respectively. It was determined that patients who did not receive home healthcare were more likely to feel tired, sad, and anxious, and the SPEED levels of these patients were found to be higher.

Conclusions
The present study is the first to identify the group of ED patients requiring PC and to determine and accordingly evaluate the current state and symptoms of this patient group using scales. Accordingly, it would be a correct approach to apply ESAS and KPS to patients in order to better evaluate the symptoms present in ED. At the same time, it was determined that home healthcare services play an important role in PC.