Symptom evaluation in palliative medicine: patient report vs systematic assessment

Abstract

The median number of symptoms found using systematic assessment was tenfold higher (p<0.001) than those volunteered. Specific detailed symptom inquiry is essential for optimal palliation in advanced disease.

Symptom management of cancer patients

“…Kanser hastalarının orta veya kuvvetli düzeyde ağrı deneyimledikleri bulunmuştur. [8][9] Akut ağrı ani doku hasarının açığa çıkardığı prostoglandin, serotonin, histamin, bradikinin ve P maddesi nedeniyle olurken [10] ; kronik ağrı KT bağlı periferal nöropati; RT bağlı brakial plexopati, RT ve cerrahi tedaviye bağlı pelvik ağrı nedeniyle oluşabilir. [11] Kronik ağrı varlığı, ayaktan takip edilen kanser hastalarının ortalama %50'sinde, metastatik kanser hastalarının ise %80-90'ında görülmektedir.…”

“…[8][9][10][11] Bu nedenden dolayı sağlık personeli; [11] • Hasta ve ailesi ile güven ilişkisi kurmalı,…”

Measuring side effects after radiotherapy for pharynx cancer

“…Bjordal has also found an underestimation of frequency and intensity of symptoms in head and neck cancer patients in a cross sectional study [87]. Homsi found a 10-fold increase in the number of reported symptoms in a population of palliative patients using a checklist compared to open-ended questions [88]. Movsas analyzed the results of a randomized study with amifostine in lung cancer patients treated with chemo-radiotherapy [89].…”

The Impact of a Novel Tool for Comprehensive Assessment of Palliative Care (MPCAT) on Assessment Outcome at 6- and 12-Month Follow-Up

“…The burden of documentation and its detraction from time available for patient care is a source of particular tension and stress for clinicians who have been shown to spend as much as 25% of their time on documentation of care. 15 However, evidence indicates that the use of standardised validated systematic assessment tools improves the effectiveness and accuracy of assessments 15,16 and can improve patient outcomes. [17][18][19] There are a number of symptom assessment tools which have been validated in a palliative care population including the Edmonton Symptom Assessment Scale (ESAS), 20 Memorial Symptom Assessment Scale (MSAS), 21 Rotterdam Symptom Checklist (RSCL), 22 Cambridge palliative care assessment schedule (CAMPAS-R), 23 Sheffield Profile for Assessment and Referral to Care, UK (SPARC) 24 and the Needs near the end-of-life care screening tool (NEST) 25 .…”