• Maren Galushko, Heidrun Golla, Julia Strupp, Ute Karbach, Claudia Kaiser, Nicole Ernstmann, Holger Pfaff, Christoph Ostgathe, and Raymond Voltz.
• 1 Department of Palliative Medicine, University Hospital , Cologne, Germany .
• J Palliat Med. 2014 Mar 1; 17 (3): 274-81.

BackgroundThe needs of patients feeling severely affected by multiple sclerosis (MS) have rarely been investigated. However this is essential information to know before care can be improved, including adding palliative care (PC) services where helpful. Since it remains unclear at what point specialized palliative care should begin for this patient group, this study focuses on needs in general.ObjectiveThe objective was to explore the subjectively unmet needs of patients feeling severely affected by MS.MethodsThe study used a qualitative cross-sectional approach for needs assessment. Fifteen patients self-reporting feeling severely affected by MS were recruited and interviewed using a combination of purposive and convenience sampling (five were accompanied by a caregiver relative). Interviews were recorded and transcribed verbatim, followed by qualitative content analysis.ResultsUnmet needs were identified in the main categories "support of family and friends," "health care services," "managing everyday life," and "maintaining biographical continuity." Patients expressed the desire for more support from their families and to be viewed as distinct individuals. They see a substantial deficit in the physician-patient relationship and in the coordination of services. A decrease in expressed unmet needs was found for patients more severely affected and less socially integrated.ConclusionsTo address the unmet needs of severely affected MS patients, health care services need to be improved and linked with existing PC services. Special attention is required to form supporting professional-patient relationships. Multiprofessional services should be accessible for patients, while integrating relatives. All services should have an individual approach to provide needs-tailored support.

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