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Symptom severity of patients with advanced cancer in palliative care unit: longitudinal assessments of symptoms improvement

Identifieur interne : 008015 ( Ncbi/Checkpoint ); précédent : 008014; suivant : 008016

Symptom severity of patients with advanced cancer in palliative care unit: longitudinal assessments of symptoms improvement

Auteurs : Shu-Yu Tai [Taïwan] ; Chung-Yin Lee [Taïwan] ; Chien-Yi Wu [Taïwan] ; Hui-Ya Hsieh [Taïwan] ; Joh-Jong Huang [Taïwan] ; Chia-Tsuan Huang [Taïwan] ; Chen-Yu Chien [Taïwan]

Source :

BMC Palliative Care [ 1472-684X ] ; 2016.

RBID : PMC:4787050

Abstract

Background

This study assessed the symptom severity of patients with advanced cancer in a palliative care unit and explored the factors associated with symptom improvement.

Methods

This study was conducted in a palliative care unit in Taiwan between October 2004 and December 2009. Symptom intensity was measured by the “Symptom Reporting Form”, and graded on a scale of 0 to 4 (0 = none, and 4 = extreme). These measures were assessed on the 1^st, 3^rd, 5^th, and 7^th Day in the palliative care unit. The study data comprised routine clinical records and patients’ demographic data. Generalized estimating equation (GEE) was used to assess the symptom improvement, and investigate the factors associated with the symptom reporting form scores.

Results

Among the 824 recruited patients with advanced cancer, pain (78.4 %), anorexia (64.4 %) and constipation (63.5 %)were the most common and severe symptom. After controlling for other factors in the multivariate GEE model, the day of palliative care administration was a significant factor associated with all of the scales, except Days 7 on the dyspnoea and oedema scales and Day 5 on the anxiety scale. In addition, patients aged ≥ 65 years exhibited significantly lower scores on the pain, sleep disturbance, depression, and anxiety scales than did those aged < 65 years. Moreover, female patients exhibited higher scores on the vomiting, anorexia, oedema, depression, and anxiety scales than did male patients. Furthermore, patients with gastrointestinal tract cancer exhibited higher scores on the constipation, vomiting, anorexia, oedema, depression, and anxiety scales and lower scores on the dyspnoea scale than did those with lung cancer. Patients with breast cancer exhibited higher scores on the oedema scale and lower scores on the anxiety scale. Patients with genitourinary cancer exhibited higher scores on the vomiting and oedema scales and lower scores on the dyspnoea scale. Patients with head, neck, and oral cancer exhibited lower scores on the oedema scale alone.

Conclusion

The symptom severity declined during the first week in the palliative care unit. In addition, differences in sex and primary cancer sites may contribute to varying degrees of symptom improvement.

Electronic supplementary material

The online version of this article (doi:10.1186/s12904-016-0105-8) contains supplementary material, which is available to authorized users.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4787050

DOI: 10.1186/s12904-016-0105-8
PubMed: 26968159
PubMed Central: 4787050

Affiliations:

Taïwan

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<series><title level="j">BMC Palliative Care</title>
<idno type="eISSN">1472-684X</idno>
<imprint><date when="2016">2016</date>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>This study assessed the symptom severity of patients with advanced cancer in a palliative care unit and explored the factors associated with symptom improvement.</p>
</sec>
<sec><title>Methods</title>
<p>This study was conducted in a palliative care unit in Taiwan between October 2004 and December 2009. Symptom intensity was measured by the “Symptom Reporting Form”, and graded on a scale of 0 to 4 (0 = <italic>none</italic>
, and 4 = <italic>extreme</italic>
). These measures were assessed on the 1<sup>st</sup>
, 3<sup>rd</sup>
, 5<sup>th</sup>
, and 7<sup>th</sup>
 Day in the palliative care unit. The study data comprised routine clinical records and patients’ demographic data. Generalized estimating equation (GEE) was used to assess the symptom improvement, and investigate the factors associated with the symptom reporting form scores.</p>
</sec>
<sec><title>Results</title>
<p>Among the 824 recruited patients with advanced cancer, pain (78.4 %), anorexia (64.4 %) and constipation (63.5 %)were the most common and severe symptom. After controlling for other factors in the multivariate GEE model, the day of palliative care administration was a significant factor associated with all of the scales, except Days 7 on the dyspnoea and oedema scales and Day 5 on the anxiety scale. In addition, patients aged ≥ 65 years exhibited significantly lower scores on the pain, sleep disturbance, depression, and anxiety scales than did those aged < 65 years. Moreover, female patients exhibited higher scores on the vomiting, anorexia, oedema, depression, and anxiety scales than did male patients. Furthermore, patients with gastrointestinal tract cancer exhibited higher scores on the constipation, vomiting, anorexia, oedema, depression, and anxiety scales and lower scores on the dyspnoea scale than did those with lung cancer. Patients with breast cancer exhibited higher scores on the oedema scale and lower scores on the anxiety scale. Patients with genitourinary cancer exhibited higher scores on the vomiting and oedema scales and lower scores on the dyspnoea scale. Patients with head, neck, and oral cancer exhibited lower scores on the oedema scale alone.</p>
</sec>
<sec><title>Conclusion</title>
<p>The symptom severity declined during the first week in the palliative care unit. In addition, differences in sex and primary cancer sites may contribute to varying degrees of symptom improvement.</p>
</sec>
<sec><title>Electronic supplementary material</title>
<p>The online version of this article (doi:10.1186/s12904-016-0105-8) contains supplementary material, which is available to authorized users.</p>
</sec>
</div>
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<author><name sortKey="Beynon, T" uniqKey="Beynon T">T Beynon</name>
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<author><name sortKey="Ding, A" uniqKey="Ding A">A Ding</name>
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<author><name sortKey="Chung, Tk" uniqKey="Chung T">TK Chung</name>
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<affiliations><list><country><li>Taïwan</li>
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<tree><country name="Taïwan"><noRegion><name sortKey="Tai, Shu Yu" sort="Tai, Shu Yu" uniqKey="Tai S" first="Shu-Yu" last="Tai">Shu-Yu Tai</name>
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<name sortKey="Chien, Chen Yu" sort="Chien, Chen Yu" uniqKey="Chien C" first="Chen-Yu" last="Chien">Chen-Yu Chien</name>
<name sortKey="Chien, Chen Yu" sort="Chien, Chen Yu" uniqKey="Chien C" first="Chen-Yu" last="Chien">Chen-Yu Chien</name>
<name sortKey="Hsieh, Hui Ya" sort="Hsieh, Hui Ya" uniqKey="Hsieh H" first="Hui-Ya" last="Hsieh">Hui-Ya Hsieh</name>
<name sortKey="Huang, Chia Tsuan" sort="Huang, Chia Tsuan" uniqKey="Huang C" first="Chia-Tsuan" last="Huang">Chia-Tsuan Huang</name>
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<name sortKey="Tai, Shu Yu" sort="Tai, Shu Yu" uniqKey="Tai S" first="Shu-Yu" last="Tai">Shu-Yu Tai</name>
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<name sortKey="Wu, Chien Yi" sort="Wu, Chien Yi" uniqKey="Wu C" first="Chien-Yi" last="Wu">Chien-Yi Wu</name>
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Symptom severity of patients with advanced cancer in palliative care unit: longitudinal assessments of symptoms improvement

Symptom severity of patients with advanced cancer in palliative care unit: longitudinal assessments of symptoms improvement

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