Beyond symptom control: Research in psychosocial and existential issues in palliative care

Stresa, a small town on the shores of the Lago Maggiore, about one hour north of Milan, Italy, was the site of the Third Research Forum of the European Association for Palliative Care (EAPC). From June 3 through 6, 2004, researchers from all across Europe, as well as investigators from North America, Australia, Japan, and Israel, gathered to review the state of palliative care research and set an agenda for the future. The setting was bucolic and tranquil; the official language was English; the accents were diverse; the accommodations were grand; the ambiance was intimate and insouciant; the dinners were elegant; the dress was stylish; the organization was impeccable; and the scholarship was of the highest level. All this, perhaps, was to be expected of an EAPC event, hosted by an Executive Scientific Committee and Research Committee headed by Franco De Conno of the Instituto di Tumori of Milano, Italy, and his colleagues. What was unexpected, however, was the prominence of research on psychosocial, existential, and spiritual aspects of palliative care at this critically important, international, palliative care research forum. Clearly, 2004 marks an important milestone for the entry of research in psychosocial and existential issues into the mainstream of academic palliative care. Palliative and Supportive Care, having just successfully completed its inaugural year of publication in 2003, is now extraordinarily and uniquely well placed to be the preeminent international palliative care journal for research in the psychosocial, existential, and spiritual aspects of palliative care.

I had the great honor to present one of the two opening plenary sessions of the Third EAPC Research Forum in Stresa, on the topic “Research methodology in psychosocial and existential issues in palliative care.” This emphasis on the psychosocial, existential, and spiritual issues in palliative care continued throughout the entire three-day conference. In addition to the symposia and research sessions on pain, physical symptom distress, health services delivery, and quality of life, fully 15% of the Forum's content focused on issues related to the psychosocial, existential, and spiritual aspects of palliative care. Several highlights included a New Research Data Session on assessment of depression and anxiety in palliative care, and an Education Session on depression and anxiety, both chaired by Mari Lloyd-Williams of the United Kingdom and Friedrich Stiefel of Switzerland. A workshop on “Spiritual and existential distress: Steps towards a research agenda” was chaired by Nathan Cherny of Israel and Birgit von Oorschot of Germany. Other sessions focused on bereavement, ethics, spiritually based interventions for helping staff, new measurement development focusing on psychosocial and existential issues, and the incorporation of spiritual and existential domains of care into academic palliative care research. For the interested reader, highlights of the forum can be obtained at the following web site: www.eapcnet.org/research2004.

One of the unforeseen delights, for me, of attending this EAPC Research Forum, was the great enthusiasm for our journal Palliative and Supportive Care. Countless researchers from across Europe and North America expressed their delight in the issues published in 2003 and their intention to submit exciting new work they are now completing. I am pleased to be able to report to our readers that we have had a very encouraging outpouring of support for the journal and a very gratifying and reassuring number of submissions of outstanding quality manuscripts. I urge all of our readers to submit manuscripts and encourage their colleagues to submit manuscripts as well. Finally, I implore all our readers to urge their institutional libraries to subscribe to our journal so that it is available more broadly and to help sustain interest in psychosocial and existential palliative care.

An important editorial note: Readers of Palliative and Supportive Care will notice a change in our masthead and the replacement of Dr. David Kissane as co-editor by Dr. Simon Wein. Dr. Kissane has recently taken on the chairmanship of the Department of Psychiatry & Behavioral Sciences at Memorial Sloan-Kettering Cancer Center. I am, of course, delighted to be working so closely with my dear friend and colleague. Dr. Kissane's move from Australia to New York City has required a change in co-editorship to maintain the international scope of our journal. I am further delighted that Dr. Simon Wein, Head, Department of Pain and Palliative Care, Peter MacCallum Cancer Centre in Melbourne, Australia, has agreed to take on the role of co-editor. Dr. Kissane will continue to serve on the Editorial Board and for this we owe him a great debt of thanks.