Needs of developing the skills of palliative care at the oncology ward: An audit of symptoms among 203 consecutive cancer patients in Finland

• Published in: Supportive care in cancer 2008, Vol.16 (1), p.3-8
• Main Authors: Salminen, E., Clemens, K. E., Syrjänen, K., Salmenoja, H.
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Aged; Aged, 80 and over; Breast Neoplasms - complications; Cancer; Depression - etiology; Dyspnea - etiology; Fatigue; Fatigue - etiology; Female; Finland; Humans; Male; Medical Audit; Medical research; Medicine; Medicine & Public Health; Middle Aged; Neoplasms - complications; Nursing; Nursing Research; Oncology; Pain - etiology; Pain Measurement; Pain Medicine; Palliative care; Palliative Care - methods; Prevalence; Prostatic Neoplasms - complications; Rehabilitation Medicine; Severity of Illness Index; Sex Factors; Sleep Initiation and Maintenance Disorders - etiology; Supportive Care International; Surveys and Questionnaires
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-007-0252-9

Background To clarify the prevalence and severity of the symptoms, 203 consecutive patients with breast, prostate and other cancers treated mainly for palliation were surveyed. Materials and methods The series includes 116 men and 87 women with the mean age of 65 years (range 27–86 years). The patients filled-up the Edmonton Symptom Assessment System (ESAS) questionnaire with 11 items describing cancer-related symptoms in the visual analogue scale (VAS). Results Altogether, 98% of the patients reported at least 1 of the 10 symptoms. There was a significant difference in the score frequencies between the 10 symptoms ( p  = 0.0001), fatigue receiving the highest frequency (50.8%) of the high scores. Fatigue was also the single most frequent symptom reported by 86.3% of the patients, followed by pain at effort (71.5%), sleeplessness (71.1%) and depression (59.0%). The most disturbing syndrome was pain ( n  = 48, 23.9%), followed by fatigue ( n  = 28, 13.9%), depression (9.5%) and dyspnoea (6.0%). Altogether, 75% had more than 5 symptoms and 10% reported all 10 symptoms. The total number of symptoms was not significantly associated with sex ( p  = 0.781) or age ( p  = 0.062), but it was associated with the diagnostic group; patients with breast cancer ( n  = 41) and those with prostate cancer ( n  = 44) reported fewer symptoms than the patients with other cancers ( n  = 116)( p  = 0.023, Kruskal–Wallis). Conclusions Symptoms related to cancer are common among patients treated with palliative indication, but if not specifically surveyed, may remain un-detected and un-treated. ESAS as a clinical tool brings more symptoms to the attention of the physicians and helps in getting a comprehensive insight into the patient’s problems.