Lack of clarity in psychosocial care
In providmg holistic support to patients,
the members of the palliative care interdisciplinary
team address not only medical
issues, but also the psychosocial issues
of the patient and family. 'Psychosocial
care', however, is less well defined than
medical (i.e. physical) care in the palliative
care literature with Payne and Haynes
(2002) describing it as 'poorly articulated'.
Psychological care is a concept that meshes
emotional support, social support and,
often, spiritual support, and one which is
used interchangeably with psychological
care and supportive care in the literature.
Indeed, in the palliative care literature
the psychosocial realm of the patient is
considered a 'shared realm', Monroe (1998)
states that: 'Whilst medical [i.e. physical]
needs will be met from the medical disciplines,
no one discipline has the monopoly
in fulfilling the non-medical [i.e. psychosocial]
roles.' We contend, however, that this
realm is more than shared: it is a contested
realm (Guilfoyle et al, 2004) with palliative
care nurses, social workers, counsellors,
psychologists, chaplains and others
all positioning themselves to address the
psychosocial needs of patients.