Symptom Distress in Patients Attending an Outpatient Palliative Radiotherapy Clinic

Bradley, Nicole; Davis, Lori; Chow, Edward

doi:10.1016/j.jpainsymman.2005.02.015

Cited by 105 publications

(101 citation statements)

References 10 publications

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“…Comparing our results to studies that specifically report ESAS scores from a palliative care unit or clinic, 26,27,[31][32][33][34][35][36][37][38] the symptom prevalence and symptom scores from these palliative patients are consistently higher than in our study. For example, in a study of 1296 patients attending a palliative radiation oncology outpatient clinic, 26 the median symptom score was 5 for fatigue, 2 for dyspnea, 3 for pain, and 2 for depression compared with our results of 3, 0, 1, and 0, respectively.…”

Section: Sarcomasupporting

confidence: 55%

“…For example, in a study of 1296 patients attending a palliative radiation oncology outpatient clinic, 26 the median symptom score was 5 for fatigue, 2 for dyspnea, 3 for pain, and 2 for depression compared with our results of 3, 0, 1, and 0, respectively. Nonetheless, despite our cohort of ''healthier'' patients, namely with PPS scores between 70% and 100% (stable), approximately 1 in 2 patients reported the presence of pain or shortness of breath.…”

Section: Sarcomasupporting

confidence: 52%

“…Moreover, the prevalence of fatigue and depression in our cohort is consistent with other reports. [26][27][28][29][30] The high prevalence of these symptoms represents areas for continued research and treatment to improve symptom management. Furthermore these results are important to practitioners because they focus on a defined ambulatory population, are population-based, and originate from validated symptom assessment tools.…”

Section: (0)mentioning

confidence: 99%

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Symptom burden and performance status in a population‐based cohort of ambulatory cancer patients

Barbera

Seow

Howell

et al. 2010

Cancer

197

128

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BACKGROUND. For ambulatory cancer patients, Ontario has standardized symptom and performance status assessment population-wide, using the Edmonton Symptom Assessment System (ESAS) and Palliative Performance Scale (PPS). In a broad cross-section of cancer outpatients, the authors describe the ESAS and PPS scores and their relation to patient characteristics. METHODS. This is a descriptive study using administrative healthcare data. RESULTS. The cohort included 45,118 and 23,802 patients' first ESAS and PPS, respectively. Fatigue was most prevalent (75%), and nausea least prevalent (25%) in the cohort. More than half of patients reported pain or shortness of breath; about half of those reported moderate to severe scores. Seventy-eight percent had stable performance status scores. On multivariate analysis, worse ESAS outcomes were consistently seen for women, those with comorbidity, and those with shorter survivals from assessment. Lung cancer patients had the worst burden of symptoms. CONCLUSIONS. This is the first study to report ESAS and PPS scores in a large, geographically based cohort with a full scope of cancer diagnoses, including patients seen earlier in the cancer trajectory (ie, treated for cure). In this ambulatory cancer population, the high prevalence of numerous symptoms parallels those reported in palliative populations and represents a target for improved clinical care. Differences in outcomes for subgroups require further investigation. This research sets the groundwork for future research on patient and provider outcomes using linked administrative healthcare data. Cancer 2010;116:5767-76.

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Section: Sarcomasupporting

confidence: 55%

Section: Sarcomasupporting

confidence: 52%

Section: (0)mentioning

confidence: 99%

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Symptom burden and performance status in a population‐based cohort of ambulatory cancer patients

Barbera

Seow

Howell

et al. 2010

Cancer

197

128

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“…More than 130 relevant articles and abstracts were identified, of which thirty-nine were primary studies published as complete peer-reviewed papers, representing 25 different institutions. Of the thirty-nine papers, thirteen were from Canada 6,11,[20][21][22][23][24][25][26][27][28][29][30] ; eight were from the United States [12][13][14]18,[31][32][33][34] ; eight were from Scandinavia (Sweden 15,[35][36][37] , Denmark [38][39] , Norway 40 , Finland 16 ); two were from Western Europe (Netherlands 41 , United Kingdom 42 ); five were from southern Europe (Switzerland 43 , Italy 17,[44][45][46] ); two were from Australia 47,48 ; and one was from Asia 49 .…”

Section: Methodsmentioning

confidence: 99%

A Review of the Reliability and Validity of the Edmonton Symptom Assessment System

2009

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BackgroundSystematic symptom reporting by patients and the use of questionnaires such as the Edmonton Symptom Assessment System (ESAS) have potential to improve clinical encounters and patient satisfaction. We review findings from published studies of the ESAS to guide use of the system and to focus research. MethodsA systematic search for articles from 1991 through 2007 found thirty-nine peer-reviewed papers from 25 different institutions, thirty-three of which focused on patients with cancer. Observations, data, and statistics were collated according to relevance, reliability, validity, and responsiveness. ResultsFindings apply predominantly to symptomatic palliative patients with advanced cancer who were no longer receiving active oncologic therapies. Uncertainty about summarizing findings arises from frequent modification of the ESAS (altered items, scales, and time periods). Overall, reliability is established for daily administration. Scores are skewed, with a floor effect, but the relative order of symptoms by mean scores is similar across studies. Emotional symptoms are poorly captured by the depression and anxiety items. An equally weighted summation of scores may estimate a construct of "physical symptom distress," which in turn is related to performance status, palliative goals, quality of life, and well-being. ConclusionsThe ESAS is reliable, but it has restricted validity, and its use requires a sound clinical process to help interpret scores and to give them an appropriate level of attention. Research priorities are to further develop the ESAS for assessing a greater number of important physical symptoms (and to target "physical symptom

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“…Outros grupos de investigação já reportaram a associação entre PS e outros sintomas, como dor oncológica. 25,26 Aqui, verificámos que os doentes com intensidade de dor mais elevada foram aqueles a quem foi prescrita mais analgesia opióide e que originaram mais pedidos de acompanhamento pela Unidade de Dor, como ficou demonstrado na análise univariável. Esta evidência clínica dispensou a incorporação destas duas variáveis no modelo multivariável.…”

Section: Discussionunclassified

Associação da Intensidade de Dor no Tempo Até à Morte dos Doentes Oncológicos Referenciados aos Cuidados Paliativos

et al. 2016

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Introduction:Pain is a common symptom experienced by cancer patients, especially in those with advanced disease. Our aim was to describe pain intensity in advanced cancer patients, referred to the palliative care unit, the factors underlying moderate to severe pain and its prognostic values. Material and Methods:This was a prospective observational study. All patients with mestastatic solid tumors and with no specific oncologic treatment were included. Pain intensity was accessed using the pain scale from Edmonton Symptom Assessment Scale, rated from 0 to 10 on a numerical scale, where zero = no pain and 10 = worst possible pain. Results: Between October 2012 and June 2015, a total of 301 patients participated in the study. The median age was 69 years, (37 -94); most of the patients were men (57%) and 64.8% had a performance status of 3/4. About 42% reported pain severity ≥ 4 and 74% were medicated with opioids. Multivariate analysis indicated a correlation between performance status and reported pain (OR: 1.7; IC 95%: 1.0 -2.7; p = 0.045). Median overall survival was 37 days (IC 95%: 28 -46). Patients reporting moderate to severe pain (pain severity ≥ 4) had a median survival of 29 days (IC 95%: 21 -37), comparing with those who had no or moderate pain with median survival of 49 days (IC 95%: 35 -63) (p = 0.022). Discussion: The performance status was associated with more intense pain. The performance status, hospitalization, intra-abdominal metastization and opioid analgesia were associated with shorter time to death in advanced cancer patients referred to palliative care. Conclusion: Cancer pain continues to be a major clinical problem in advanced cancer patients. Keywords: Neoplasms; Pain Measurement; Palliative Care. INTRODUÇÃOA dor é uma experiência subjetiva e multidimensional, frequentemente relatada nos doentes oncológicos, principalmente nos que se encontram numa fase mais avançada da sua doença.1-3 Do mau controlo sintomático que está associado à fase avançada do cancro, a dor é o sintoma que frequentemente surge descrito como o mais angustiante, tendo elevado impacto negativo na qualidade de vida e deteriorando a capacidade do doente em aderir ao tratamento oncológico ou alcançar uma morte tranquila.

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Symptom Distress in Patients Attending an Outpatient Palliative Radiotherapy Clinic

Cited by 105 publications

References 10 publications

Symptom burden and performance status in a population‐based cohort of ambulatory cancer patients

Symptom burden and performance status in a population‐based cohort of ambulatory cancer patients

A Review of the Reliability and Validity of the Edmonton Symptom Assessment System

Associação da Intensidade de Dor no Tempo Até à Morte dos Doentes Oncológicos Referenciados aos Cuidados Paliativos

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