Cancer Symptom Assessment Instruments: A Systematic Review

Kirkova, Jordanka; Davis, Mellar P.; Walsh, Declan; Tiernan, Eoin; O’Leary, Norma; LeGrand, Susan B.; Lagman, Ruth; Russell, Kathleen M.

doi:10.1200/jco.2005.02.8332

Cited by 248 publications

(201 citation statements)

References 112 publications

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“…Physical symptoms are commonly dissociated from cognitive and affective symptoms. Previous studies have suggested that 3 symptoms, occurring at the same time, might be considered a cluster, 12,20,21 and several studies demonstrated correlations (tight, close, or frail) between clusters. 22,23 There has been growing awareness that common biologic mechanisms may underlie or contribute to simultaneously reported symptoms 24 and there is clinical evidence that symptoms grouped in a cluster may share a common biologic mechanism.…”

Section: Discussionmentioning

confidence: 99%

Application of distance matrices to define associations between acute toxicities in colorectal cancer patients receiving chemotherapy

Aprile

Ramoni

Keefe

et al. 2007

Cancer

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Section: Discussionmentioning

confidence: 99%

Application of distance matrices to define associations between acute toxicities in colorectal cancer patients receiving chemotherapy

Aprile

Ramoni

Keefe

et al. 2007

Cancer

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“…It is known that patients with advanced cancer suffer many physical and psychological symptoms, and these issues frequently are not addressed well in conventional care. 8,[23][24][25] In the current study, we characterized the distress symptoms, interventions, and outcomes of patients who were admitted to the ICU and referred to a PCT in a cancer center. We observed that a significant number of ICU patients had severe physical and emotional distress.…”

Section: Discussionmentioning

confidence: 99%

Symptom distress, interventions, and outcomes of intensive care unit cancer patients referred to a palliative care consult team

Delgado-Guay

Parsons

et al. 2009

Cancer

110

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BACKGROUND:The symptom burden of intensive care unit (ICU) patients who are referred to a palliative care team (PCT) has not been characterized to the authors' knowledge, and the response of these symptoms to the palliative care intervention has not been reported.METHODS:The authors retrospectively reviewed PCT consults for ICU patients who were seen between July 2006 and October 2007. To characterize symptom distress and outcomes in ICU patients who were referred to PCT in a cancer center, information and descriptive statistics about patients' demographics, comorbidities, PCT findings, interventions, and outcomes were obtained. The chi‐square test was used to analyze ICU and PCT mortality, and the signed‐rank test was used to analyze PCT interventions.RESULTS:Of 1637 PCT consults, 88 consults (5%) were from the ICU. The median patient age was 60 years (range, 22‐87 years), and 41 patients (46%) were women. The types of cancers were hematologic (19 patients; 22%), gastrointestinal (19 patients; 22%), lung (18 patients; 20%), and others (24 patients; 26%). Nineteen patients were on mechanical ventilation (MV), and 24 patients were on bilevel positive airway pressure (BIPAP). The findings were delirium (71 patients; 81%), dyspnea (67 patients; 76%), pain (74patients; 84%), fatigue (84 patients; 95%), and anxiety (57 patients; 65%). The interventions used were opioid management (99%), steroids (70%), antipsychotics (76%), and counseling (100%), do not resuscitate conversion (62 of 88 patients; 70%), withdrawal of MV (15 of 19 patients; 79%), and withdrawal of BIPAP (26 of 26 patients; 100%). Improvement was reported in pain (67 patients; 90%), dyspnea (60 patients; 90%), anxiety (51 patients; 80%), and delirium (31 patients; 44%). Thirty‐five patients (40%) were transferred to the palliative care unit (PCU). Fifty‐one ICU/PCT patients (58%) died during admission versus 130 of 1549 (8%) non‐ICU PCT patients (P < .0001). Twenty‐three of 35 patients who were transferred to the PCU (66%) died there versus 212 of 629 patients (34%) who were admitted to the PCU from another service (P < .0001). Thirty‐seven of 88 ICU/PCT patients (42%) were discharged alive.CONCLUSIONS:ICU patients who are referred to the PCT have severe symptom distress. The PCT was able to identify multiple problems and make numerous pharmacologic and nonpharmacologic recommendations that improved these symptoms, including the participation in do not resuscitate conversion and withdrawal of MV and BIPAP. Although many patients in this population died, a significant subset, including those who were transferred to the PCU, survived to discharge. Cancer 2009. © 2009 American Cancer Society.

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“…Many patients with advanced cancer will develop physical and psychological symptoms related to their disease, treatments, or comorbidities. 2,3 These symptoms, which can significantly impair the patient's quality of life and family dynamics, are infrequently treated in conventional care. Palliative care programs have been developed to fill this gap in care.…”

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confidence: 99%

Impact of Combined Hospice Care on Terminal Cancer Patients

Loke

Rau

Huang

2011

Journal of Palliative Medicine

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Background: Many patients with advanced cancer will develop physical and psychological symptoms related to their disease. These symptoms are infrequently treated by conventional care. Palliative care programs have been developed to fill this gap in care. However, there are limited beds in hospice units. To allow more terminal cancer patients to receive care from a hospice team, a combined hospice care system was recently developed in Taiwan. This study is a report of our experiences with this system. Patients and Methods: From January to December 2009, terminal cancer patients who accepted consultation from a hospice team for combined hospice care were enrolled in the study. Demographic data, clinical symptoms, referring department, type of cancer, and outcome were analyzed. Results: A total of 354 terminal cancer patients in acute wards were referred to a hospice consulting team. The mean patient age was 61 years, and the proportion of males was 63.28%. After combined hospice care, there was a significant improvement in the sign rate of do-not-resuscitate (DNR) orders from 41.53% to 71.47% ( p < 0.0001), and awareness of disease prognosis from 46.05% to 57.69% ( p ¼ 0.0006). Combined hospice care also enabled 64.21% of terminal cancer patients who were not transferred to hospice ward to receive combined care by a hospice consulting team while in acute wards, thus increasing the hospice utilization of terminal cancer patients. The major symptoms presented by the patients were pain (58%), dyspnea (52%), constipation (45%), and fatigue (23%). Conclusions: Through the hospice consulting system, hospice combined care has a positive effect on the utilization of hospice care, rate of DNR signing and quality of end-of-life care for terminal cancer patients.

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Cancer Symptom Assessment Instruments: A Systematic Review

Cited by 248 publications

References 112 publications

Application of distance matrices to define associations between acute toxicities in colorectal cancer patients receiving chemotherapy

Application of distance matrices to define associations between acute toxicities in colorectal cancer patients receiving chemotherapy

Symptom distress, interventions, and outcomes of intensive care unit cancer patients referred to a palliative care consult team

Impact of Combined Hospice Care on Terminal Cancer Patients

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