Association of physical and psychological symptom burden with time to death among palliative cancer outpatients

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19523-19523
Author(s):  
C. Zimmermann ◽  
N. Barmala ◽  
S. Zarinehbaf ◽  
L. W. Le ◽  
W. Y. Cheung
Keyword(s):  
Psychological Symptom ◽  
Symptom Burden ◽  
Stage Iv ◽  
Symptom Assessment ◽  
Physical Symptoms ◽  
Initial Assessment ◽  
Cancer Site ◽  
Shortness Of Breath ◽  
Time To Death ◽  
Edmonton Symptom Assessment Scale

19523 Background: Patients with terminal cancer have a high symptom burden, which tends to increase as death approaches. Previous studies have assessed the association of symptom burden with time to death (TTD) among inpatients or using baseline data for patients enrolled in a trial. Our purpose was to determine the association of symptom burden with TTD in patients who were followed by an outpatient palliative oncology clinic (OPOC). Methods: Cancer patients seen in the OPOC between January 2005 to June 2006 and who subsequently died were identified from the palliative care database. The last outpatient Edmonton Symptom Assessment Scale (ESAS) score completed in clinic was compared among patients in the last 4 months of life. Multiple linear regression was used to determine the association of ESAS total symptom distress score (SDS), physical subscore (PHS), psychological subscore (PSS) and individual symptom scores with demographic parameters, disease characteristics and TTD. Results: In total, 198 patients were identified. All patients had stage IV cancer, the mean age was 63.8 years (SD 12.9) and 55% were male. Median survival time from initial assessment was 6.6 weeks (range 0.3 to 16.7) and mean SDS was 46.0 (SD 18.0). Sites of cancer included gastrointestinal (36%), lung (12%), genitourinary (10%), hematological (8%), gynecological (8%), breast (7%) and others (19%). There was no significant association between symptom burden and gender, age or cancer site. TTD was significantly associated with SDS (p<0.001) and PHS (p<0.001), but not with PSS (p=0.19). Individual symptoms most strongly associated with TTD were fatigue (p=0.001), appetite (p=0.001), drowsiness (p=0.0005) and shortness of breath (p=0.0008). There was no significant association between TTD and depression (p=0.24) or anxiety (p=0.20). Conclusions: In this outpatient palliative cancer population, the association between TTD and symptoms held true only for physical symptoms, particularly constitutional symptoms and shortness of breath which are amenable to therapy. Symptoms in palliative patients should be rigorously assessed and treated, regardless of prognosis and especially at end-of-life. No significant financial relationships to disclose.

scholarly journals Couples symptom burden in oncology care: Perception of self and the other.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 213-213
Author(s):  
Gabriel Lopez ◽  
Kathrin Milbury ◽  
Yisheng Li ◽  
Minxing Chen ◽  
Casey Dutton ◽  
...  
Keyword(s):  
Global Health ◽  
Financial Distress ◽  
Psychological Symptoms ◽  
Symptom Burden ◽  
Symptom Assessment ◽  
Physical Symptom ◽  
Physical Symptoms ◽  
Psychological Stressors ◽  
Edmonton Symptom Assessment Scale ◽  
Symptom Assessment Scale

213 Background: Cancer survivors and their caregivers have symptoms that wax and wane over time and are interrelated. We report on the results of a communication survey exploring symptom burden in couples presenting for care in an integrative oncology (IO) clinic. Methods: Couples were approached for participation while waiting for an IO service (Physician Consultation, Massage, Acupuncture, Physical Therapy, Nutrition). 50 patients and their partner completed the Edmonton Symptom Assessment Scale (ESAS; 0-10, 10 worst). Patient and partner each completed two ESAS forms: one for themselves and one for their perception of the other’s symptoms. Each also completed a Global Health scale (PROMIS 10). ESAS distress subscales analyzed included Psychological (PSS) and Physical (PHS). Paired t-tests were used to examine all measures. Results: Patients (58% female) had most frequent cancer diagnoses of breast (22%) and gastrointestinal (18%). Patients rated their own physical symptoms of Fatigue (p = 0.002), Nausea (p < 0.001), Drowsiness (p = 0.032), Appetite (p = 0.008), and Shortness of Breath (p = 0.001) significantly higher than their partner’s rating of their symptoms. Patient self-rating for psychosocial symptoms of anxiety and depression was not significantly different from partner rating of patient symptoms. Partners were more accurate rating psychological symptoms (ESAS PSS, patient 3.89 vs partner 3.72, p = 0.836) and less accurate interpreting physical symptoms (ESAS PHS, patient 16.43 vs partner 9.94, p < 0.001). Except for Sleep, Financial Distress, and Spiritual Pain, partners rated all their own symptoms significantly lower compared to patient’s rating of them (all p’s < 0.001). Patients reported significantly lower global health (36.9 vs 42.9, p < 0.001) and physical health (16.6 vs 20.2, p < 0.001); no differences were observed for mental health for patients vs caregivers (14.2 vs 15.12, p = 0.1). Conclusions: Our findings suggest that partners may better perceive psychological stressors expressed by patients but may be less sensitive to physical symptoms. Interventions aimed at assisting caregivers in better understanding patient physical symptom burden are warranted.

Hope, Symptoms, and Palliative Care

2016 ◽  
Vol 34 (3) ◽  
pp. 223-232 ◽  
Author(s):  
Mellar P. Davis ◽  
Ruth Lagman ◽  
Armida Parala ◽  
Chirag Patel ◽  
Tanya Sanford ◽  
...  
Keyword(s):  
Palliative Care ◽  
Marital Status ◽  
Multivariable Analysis ◽  
Symptom Burden ◽  
Symptom Assessment ◽  
Well Being ◽  
Cancer Site ◽  
Cancer Symptoms ◽  
Severity Scores ◽  
Edmonton Symptom Assessment Scale

Background: Hope is important to patients with cancer. Identifying factors that influence hope is important. Anxiety, depression, fatigue, and pain are reported to impair hope. The objective of this study was to determine whether age, gender, marital status, duration of cancer, symptoms, or symptom burden measured by the sum of severity scores on the Edmonton Symptom Assessment Scale (ESAS) correlated with hope measured by the Herth Hope Index (HHI). Methods: Patients with advanced cancer in a palliative care unit participated. Demographics including age, gender, marital status, cancer site, and duration of cancer were collected. Individuals completed the ESAS and HHI. Spearman correlation and linear regression were used to assess associations adjusting for gender (male vs female), age (< 65 vs ≥ 65 years), marital status (married or living with a partner vs other), and duration of cancer (≤ 12 vs > 12 months). Results: One hundred and ninety-seven were participated in the study, of which 55% were female with a mean age of 61 years (standard deviation 11). Hope was not associated with gender, age, marital status, or duration of cancer. In univariable analysis, hope inversely correlated with ESAS score (−0.28), lack of appetite (−0.22), shortness of breath (−0.17), depression (−0.39), anxiety (−0.32), and lack of well-being (−0.33); only depression was clinically relevant. In multivariable analysis, total symptom burden weakly correlated with hope; only depression remained clinically significant. Discussion: This study found correlation between symptom burden and hope was not clinically relevant but was so for depression. Conclusion: Among 9 ESAS symptoms, only depression had a clinically relevant correlation with hope.

scholarly journals Integrating Palliative Care Services in Ambulatory Oncology: An Application of the Edmonton Symptom Assessment System

2017 ◽  
Vol 13 (4) ◽  
pp. e401-e407 ◽  
Author(s):  
Sherri L. Rauenzahn ◽  
Susanne Schmidt ◽  
Ifeoma O. Aduba ◽  
Jessica T. Jones ◽  
Nazneen Ali ◽  
...  
Keyword(s):  
Palliative Care ◽  
Standard Deviation ◽  
Symptom Burden ◽  
Symptom Assessment ◽  
Cost Of Care ◽  
Assessment System ◽  
Referral System ◽  
Referral Rates ◽  
Ambulatory Oncology ◽  
Edmonton Symptom Assessment Scale

Purpose: Research in palliative care demonstrates improvements in overall survival, quality of life, symptom management, and reductions in the cost of care. Despite the American Society of Clinical Oncology recommendation for early concurrent palliative care in patients with advanced cancer and high symptom burden, integrating palliative services is challenging. Our aims were to quantitatively describe the palliative referral rates and symptom burden in a South Texas cancer center and establish a palliative referral system by implementing the Edmonton Symptom Assessment Scale (ESAS). Methods: As part of our Plan-Do-Study-Act process, all staff received an educational overview of the ESAS tool and consultation ordering process. The ESAS form was then implemented across five ambulatory oncology clinics to assess symptom burden and changes therein longitudinally. Referral rates and symptom assessment scores were tracked as metrics for quality improvement. Results: On average, one patient per month was referred before implementation of the intervention compared with 10 patients per month after implementation across all clinics. In five sample clinics, 607 patients completed the initial assessment, and 430 follow-up forms were collected over 5 months, resulting in a total of 1,037 scores collected in REDCap. The mean ESAS score for initial patient visits was 20.0 (standard deviation, 18.1), and referred patients had an initial mean score of 39.0 (standard deviation, 19.0). Conclusion: This project highlights the low palliative care consultation rate, high symptom burden of oncology patients, and underuse of services by oncologists despite improvements with the introduction of a symptom assessment form and referral system.

Symptom Profiles in Patients with Chronic Lymphocytic Leukemia: Validation and Application of the M. D. Anderson Symptom Inventory.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1393-1393
Author(s):  
Xin Shelley Wang ◽  
Tito R. Mendoza ◽  
Jackie B Broadway ◽  
Gary M. Mobley ◽  
Michael Keating ◽  
...  
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Symptom Severity ◽  
Symptom Burden ◽  
Physical Symptoms ◽  
Lymphocytic Leukemia ◽  
Shortness Of Breath ◽  
Symptom Inventory ◽  
Symptom Profile ◽  
Patient Reported ◽  
Symptom Group

Abstract Abstract 1393 Poster Board I-415 Chronic lymphocytic leukemia (CLL) is the most prevalent form of adult leukemia. Patients with CLL have a long life expectancy and little attention has been paid to the symptom burden that accompanies this disease. We, therefore, wanted to explore the reliability and validity of the M. D. Anderson Symptom Inventory (MDASI) in measuring the symptom burden of patients with CLL. The MDASI is an established, reliable and validated tool for assessing cancer-related symptoms regardless of therapy or specific cancer diagnosis.1 The MDASI measures the most common symptoms across most cancer types and treatments: 13 items assess symptom severity at its worst in the last 24 hours and 6 items assess symptom-related interference in the last 24 hours, all rated on a 0–10 numeric scale. These 19 symptom and interference items comprise the “core” MDASI. We enrolled 126 consecutive patients with CLL being followed at our outpatient center. Patients eligible for this study were required to be speak English and have a pathological diagnosis of CLL. A clinical nurse conducted interviews, had patients complete self-administered MDASI, and collected information from patients' medical record. Sixty-three % of the patients were male, 95% were white non-Hispanic, the mean age was 59 years (range 29-79) with 27% of them age 65 years or older. Eighty-three % of the patients had Rai stage 0-2, and 56% were untreated. Factor analysis of the MDASI items resulted in a three-factor solution (physical symptoms, psychological symptoms, and gastrointestinal symptoms), which satisfied criteria for interpretability and model fit in a confirmatory setting. Cronbach coefficient alphas for the MDASI were 0.89 for the symptom severity subscale and 0.94 for the interference subscale. Convergent validity showed that the two MDASI subscales were significantly correlated with similar subscales of the SF-12 (12-Item Short-Form Health Survey). The most severe patient-reported MDASI symptoms were fatigue, disturbed sleep, drowsiness, distress, and difficulty remembering. Patients with poorer performance status (ECOG PS 2 vs. 1 vs. 0) reported significantly higher severity for both core MDASI and total interferences (all P < .001). Patients with higher Rai staging [3-4 vs 0-2] reported significantly higher severity on core symptoms and interferences (P<.01), especially on fatigue, nausea, sleep, shortness of breath, drowsiness (All P<.05), and lack of appetite (P<.001). Older patients (aged 65 years and older) had significantly higher fatigue, shortness of breath, and lack of appetite [P<.001], but lower sadness. We observed that female reported significantly higher pain and sadness (All <.05). Patients with more prior chemotherapy [1 or more vs. 0 cycles chemotherapy) reported significantly higher symptom severity for core items on MDASI [P=.013] and higher symptom interferences [P=.001], especial on fatigue, shortness of breath, and drowsiness (All P<.01). Sixty-one percent of the sample rated at least one symptom as moderate to severe (≥5 on the MDASI's 0–10 scale). In cluster analysis, approximately 30% of patients belonged to the high-symptom group (Fig 1: symptom severity by items on MDASI for both high and low symptom group). The most burdens from symptoms were interference of working, enjoyment of life and activity. In conclusion, our data analysis showed that the MDASI is a reliable and valid tool for assessing symptom severity and interference with daily functioning in patients with CLL. The MDASI symptom profile demonstrated that almost one-third of patients had significantly higher symptom severity. This validated MDASI provides a useful tool for measuring symptom burden and monitor symptom control in patients with CLL. Figure Patient reported symptom severity (0-10 scale) on MDASI: majority of patient (70%) had multiple low symptom profile Figure. Patient reported symptom severity (0-10 scale) on MDASI: majority of patient (70%) had multiple low symptom profile Disclosures: No relevant conflicts of interest to declare.

Efficacy of acupuncture (ACU) therapy for cancer-related pain management in oncology patients (pts).

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 196-196
Author(s):  
Jai Narendra Patel ◽  
Katherine Miller ◽  
James Thomas Symanowski ◽  
Connie Edelen
Keyword(s):  
Neuropathic Pain ◽  
Symptom Burden ◽  
Symptom Assessment ◽  
Patient Specific ◽  
Tumor Type ◽  
Logistic Regression Models ◽  
Multiple Observations ◽  
Significant Pain ◽  
Edmonton Symptom Assessment Scale ◽  
Pain Improvement

196 Background: Cancer-related pain negatively affects symptom burden, morbidity, and mortality. Evidence suggests the use of ACU to relieve cancer-related pain. We investigated ACU efficacy and patient-specific factors associated with pain improvement. Methods: Medical charts were reviewed from oncology pts receiving ACU and concurrent palliative medicine management. Pre- and post-ACU pain scores, as assessed by the Edmonton Symptom Assessment Scale (ESAS), were measured at each session. Univariate logistic regression models, including an over-dispersion parameter to account for multiple observations per pt, were used to investigate the association between patient-specific variables (Table) and significant pain improvement, defined as a ≥ 2-point reduction in ESAS pain score, at each session. Results: A total of 122 ACU sessions from 53 pts were included in the analysis. Significant pain improvement was observed in 47% of all sessions (mean reduction 1.8). Baseline non-neuropathic pain was significantly associated with a higher odds of achieving pain reduction (OR 2.351; P = 0.047). Conversely, an opposite association was identified for baseline neuropathic pain (OR 0.421; P = 0.048). Age, stage, number of sessions and tumor type were not significantly associated with pain improvement, although several trends were noted (Table 1). Conclusions: ACU is an appropriate adjunct therapy for cancer-related pain, particularly for non-neuropathic pain. Larger studies to confirm patient-specific variables and further investigation into therapy related side effects will assist in determining a personalized approach to ACU therapy in the oncology population. [Table: see text]

The influence of a cachexia clinic on palliative care integration in oncology.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 124-124
Author(s):  
Diane Portman ◽  
Sarah Thirlwell ◽  
Kristine A. Donovan
Keyword(s):  
Palliative Care ◽  
Weight Loss ◽  
Advanced Cancer ◽  
Symptom Burden ◽  
Symptom Assessment ◽  
Cancer Center ◽  
Edmonton Symptom Assessment Scale ◽  
Symptom Assessment Scale ◽  
The Impact

124 Background: Appetite and weight loss are common in patients with advanced cancer and specialized cachexia clinics have been established to address these symptoms. Given the association between anorexia/cachexia and other adverse symptoms, these patients may also benefit from specialty level palliative care (PC). However, referral to outpatient specialty level PC is often delayed or does not occur. We sought to examine the prevalence of other factors associated with appetite and weight loss in patients with advanced cancer and the impact of a specialized cachexia clinic on identification and treatment of other PC needs. Methods: The records of patients referred by their Oncologist to the cachexia clinic of a cancer center from August 2016 to June 2017 were reviewed retrospectively. Subjects who had been referred to PC by their Oncologist were excluded. Patients had been assessed for symptom burden using the Edmonton Symptom Assessment Scale (ESAS-r). Patients identified with PC needs had been referred to the PC clinic for follow-up within 30 days after cachexia clinic consultation. Results: Thirty subjects were evaluated in the cachexia clinic (average age 68 years; 63% female). The predominant diagnosis was lung cancer (70%). An average of 6 symptoms per patient were in the moderate to severe range on ESAS, excluding appetite. Depression, fatigue and pain were most common. The average cachexia clinic total ESAS score was 51.61. Only 17% of patients had completed advance directives. Ninety-three % of patients were referred to PC and 68% were seen. The average number of PC visits was 2.79. Within the PC clinic, advance directive completion increased to 37%, goals of care discussion occurred with 50% and 17% received hospice referrals. At the most recent follow-up in the PC clinic, the average total ESAS score had decreased by 11.44 (22%) and all ESAS item scores were improved on average. Conclusions: The cachexia clinic proved a useful means to identify other PC needs and achieve effective PC referrals. We suggest this is proof of concept that specialty clinics can be a meaningful way to achieve an earlier entry point to comprehensive PC in patients who were not previously referred by their Oncologists.

Utilizing patient reported outcomes for patients recieving oral chemotherapy.

2017 ◽  
Vol 35 (8_suppl) ◽  
pp. 190-190 ◽  
Author(s):  
Emily R. Mackler ◽  
Kathleen W. Beekman ◽  
Laura Bushey ◽  
Anne Gentz ◽  
Kathleen Davis ◽  
...  
Keyword(s):  
Side Effects ◽  
Side Effect ◽  
Patient Reported Outcomes ◽  
Symptom Burden ◽  
Symptom Assessment ◽  
Oral Chemotherapy ◽  
Severe Side Effect ◽  
Management Support ◽  
Patient Reported ◽  
Edmonton Symptom Assessment Scale

190 Background: Management of oral chemotherapy presents many challenges to oncology practitioners. The purpose of this study is to describe how incorporation of patient reported outcomes (PRO) for patients receiving oral chemotherapy can identify those patients who are experiencing moderate to severe symptom burden and nonadherence. Methods: As part of a statewide quality collaborative, we wished to improve our monitoring of patients receiving oral chemotherapy. The quality collaborative created a PRO assessment that includes a revised Edmonton Symptom Assessment Scale (ESAS), a single-item adherence question, reasons for nonadherence, the patient’s most bothersome symptom and questions related to patient confidence. Our medical assistants provide the assessment to the patient before each appointment. Results: Patients completing the PRO during the first 3 months (7/7/16 – 9/27/16) were evaluated. We had 32 assessments completed by 23 patients. The oral chemotherapy prescribed were capecitabine (48%), erlotinib (13%), temozolomide (13%), and not recorded (26%). Of the 29 completed ESAS assessments, 72% included at least 1 moderate side effect, and 48% included at least 1 severe side effect. 29% of patients reported low-moderate confidence to self-manage their symptoms. Less than excellent adherence (<80% adherence) was reported in 30% of patients with the most commonly reported reason being related to side effects or concerns about side effects. Conclusions: Use of PROs in our oral chemotherapy population identified a large proportion of patients experiencing moderate to severe side effects. Further assessment of how this compares to what patients report to their oncologist during their visits will be reviewed. In addition, we found that approximately 30% of our patients are nonadherent to their oral chemotherapy. This is consistent with recent publications. We plan to continue assessing patient outcomes and utilizing the data we collect to improve patient self-management support.

Are real-world patient-reported outcomes associated with survival in patients with advanced pancreatic cancer?

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 205-205
Author(s):  
Wei Fang Dai ◽  
Jaclyn Marie Beca ◽  
Helen Guo ◽  
Lucy Qiao ◽  
Wanrudee Isaranuwatchai ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Symptom Score ◽  
Patient Reported Outcomes ◽  
Cox Model ◽  
Advanced Pancreatic Cancer ◽  
Symptom Burden ◽  
Physical Symptoms ◽  
Funding Program ◽  
Patient Reported ◽  
Edmonton Symptom Assessment Scale

205 Background: Advanced pancreatic cancer (APC) patients often have a substantial symptom burden. In Ontario, patients visiting cancer clinics routinely complete the Edmonton Symptom Assessment Scale (ESAS), which screens for 9 symptoms (scale: 0-10). Using ESAS, we explored the association between baseline patient-reported outcomes and overall survival (OS). Methods: APC Patients with ESAS records prior to receiving publicly-funded drugs from November 2008 to March 2016 were identified from Cancer Care Ontario’s New Drug Funding Program and Symptom Management databases. We examined 3 baseline composite ESAS scores: Total Symptom Distress Score (TSDS: all 9 symptoms), Physical Symptom Score (PHS: 6/9 symptoms), and Psychological Symptom Score (PSS: 2/9 symptoms); Composite scores greater than a threshold (defined as number of symptoms in composite score multiplied by clinically relevant score (≥4)) were categorized as High Symptom Burden (TSDS ≥ 36, PHS ≥ 24, PSS ≥ 8). The primary endpoint, OS, was assessed using Kaplan-Meier. Multivariable Cox models were used to adjust for age, gender, income, prior therapies (surgery, adjuvant gemcitabine, radiation), and Charlson's comorbidity. Analysis was repeated in a sub-cohort with identifiable ECOG status and stage. Results: We identified 2,199 APC patients (mean age 64 years, 55% male) with ESAS records prior to receiving gemcitabine (54%), FOLFIRINOX (40%) or gemcitabine/nab-paclitaxel (6%). Crude median survival was 4.5 and 7.3 months for patients with high and low TSDS burden, respectively (HR = 1.50, 95% CI: 1.36, 1.66). After adjustment with multivariable Cox model, high TSDS burden was associated with lower OS (HR = 1.47, 95% CI: 1.33, 1.63). Similar trends were observed for PHS and PSS. When adjusting for both PHS and PSS in a Cox model, only the effect of PHS remained significant. In the sub-cohort (n = 393), high TSDS burden (HR = 1.34, 95% CI: 1.04, 1.73) was associated with lower OS, after adjusting for ECOG and stage. Conclusions: Among APC patients, a higher burden of patient-reported symptoms, via ESAS, at baseline was associated with reduced OS. The effect was prominent for physical symptoms, even after adjusting for treatment, stage and ECOG.

Preliminary validation of the Edmonton Symptom Assessment Scale – Acute Leukemia (ESAS-AL) in patients with acute leukemia (AL).

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 210-210
Author(s):  
Columbe Tricou ◽  
Kenneth Mah ◽  
Carmine Malfitano ◽  
Anne Rydall ◽  
Aaron David Schimmer ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Scale Validation ◽  
Symptom Assessment ◽  
Physical Symptoms ◽  
Assessment Scale ◽  
Preliminary Evaluation ◽  
Preliminary Validation ◽  
Edmonton Symptom Assessment Scale ◽  
Symptom Assessment Scale ◽  
Highly Correlated

210 Background: Patients with AL have numerous symptoms resulting from their disease and its treatment. Here we report on a preliminary evaluation of an ESAS version including AL-specific symptoms (ESAS-AL). Methods: Forty-two inpatients with newly-diagnosed AL (31 AML, 11 ALL), receiving induction chemotherapy, completed baseline assessments with the ESAS-AL and the Memorial Symptom Assessment Scale (MSAS) as part of a clinical trial. The ESAS-AL includes the nine usual ESAS symptoms (rated from 0-10), as well as five symptoms reported by patients with AL in a previous longitudinal study: trouble sleeping, mouth sores, diarrhea, constipation, and itching. Correlations between each ESAS symptom and the corresponding MSAS symptom (rated 1-4) were calculated using Spearman’s correlation. Results: The mean age was 52.86 (SD 15.84). Most correlations were moderate to large and were highly significant (Table). Correlations ranged from 0.86 (ESAS-AL/MSAS Itching) to 0.20 (ESAS-AL Anxiety/MSAS Worried). Correlations for 4 physical symptoms specific to ESAS-AL (itching, diarrhea, mouth sores, and constipation) were among the highest (rs>.70). Correlations between ESAS-AL trouble sleeping and MSAS difficulty sleeping and between ESAS-AL anxiety and MSAS worried were lowest (rs<.30). ESAS-anxiety correlated better with MSAS nervous (rs=.61). Conclusions: Well-defined ESAS-AL physical symptoms are highly correlated with equivalent MSAS symptoms, whereas less well-defined symptoms have weaker correlations. These findings provide preliminary support for the validity of the ESAS-AL. Further data collection for larger-scale validation is ongoing. [Table: see text]

scholarly journals Symptom Burden of Patients with Haematological Malignancy

2021 ◽  
Vol 46 (3) ◽  
pp. 196-203
Author(s):  
Syeda Subrina Siddika ◽  
Md Anisur Rahman ◽  
AKM Mynul Islam ◽  
Syeda Tasfia Siddika ◽  
Khursheda Akhtar ◽  
...  
Keyword(s):  
Family Income ◽  
Haematological Malignancy ◽  
Symptom Control ◽  
Psychological Symptom ◽  
Symptom Burden ◽  
Physical Symptoms ◽  
Symptom Distress ◽  
Cross Sectional ◽  
Multiple Symptoms ◽  
Distress Scale

Background: Haematological malignancy and its treatment produce multiple symptoms that significantly distress patients and impair function. Symptoms caused by treatment may delay treatment or lead to premature treatment termination and residual treatment-related symptoms often complicate post treatment rehabilitation. When treatment is no longer possible, symptom control becomes the focus of cancer care. Objectives: The study was aimed to determine the symptom burden of the haematological malignancy patients. Methods: A cross sectional study was conducted from July 2015 to June 2016 among the haematological malignancy patients. A total of 316 haematological malignancy adult (age ≥18 years) patients were purposively selected from haematology department of two tertiary level of hospitals in Dhaka city. Face to face interviews were taken from the diagnosed haematological malignancy patients admitted in the hospital and attending outdoor using questionnaire based on symptom distress scale (SDS). Results: Mean age was 39 years and most of the patients suffering from Acute Leukemia 162(51.3%). Mean monthly family income was around 22235 taka and 120(37.9%) patients were unemployed. Patients with haematological malignancy had a considerable physical and psychological symptom burden which ranged from 94.3% for fatigue to 8.5% for difficulty in concentration. Physical symptoms such as fatigue 127 (40.2%), change in appetite 86 (27.2%), pain1 81 (25.6%), insomnia44 (13.9%) caused severedistress and psychological symptoms include change in appearance 37 (11.7%) and outlook 33 (10.4%) were sever distressing. Significant association (p<0.001) was to be found between occupation and symptom distress where 82 (68.4%) unemployed and 51 (66.3%) housewife had moderate/sever symptom distress. Respondents who managed their treatment expenditure by loan and asset sell 11 (84.6%) had significant(p=0.004) moderate/sever distress. Patients having less than one month of diagnosis 47(72.3%) and admitted in inpatient 114 (66.6%) had significant higher moderate/sever symptom distress(p=0.03) and (p<0.001) respectively. Conclusion: Patients with haematological malignancy were likely to have multiple symptoms and comprehensive symptom assessment was suggested throughout. The introduction of supportiveor palliative care services during times of increased symptom burden may assist haematologists and other careers in the management of their patient’s distress and quality of life. Bangladesh Med Res Counc Bull 2020; 46(3): 196-203

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