Symptom screening for constipation in oncology: getting to the bottom of the matter
| Autor: | Yvonne W. Leung, Stephane Laframboise, Sean Molloy, Alyssa Macedo, Caroline Sanders, Madeline Li, Bryan Gascon, Chieh-Hsin Lee |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Constipation Pain medicine Context (language use) Disease Gynecologic oncology 03 medical and health sciences 0302 clinical medicine hemic and lymphatic diseases Internal medicine Intervention (counseling) Neoplasms Medicine Humans 030212 general & internal medicine Patient Reported Outcome Measures Aged business.industry Nursing research Middle Aged Patient burden Oncology 030220 oncology & carcinogenesis Female medicine.symptom Symptom Assessment business |
| Zdroj: | Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 27(7) |
| ISSN: | 1433-7339 |
| Popis: | This study seeks to determine whether specific screening for constipation will increase the frequency of clinician response within the context of an established symptom screening program. A “constipation” item was added to routine Edmonton Symptom Assessment System (ESAS) screening in gynecologic oncology clinics during a 7-week trial period, without additional constipation-specific training. Chart audits were then conducted to determine documentation of assessment and intervention for constipation in three groups of patients, those who completed (1) ESAS (n = 477), (2) ESAS-C with constipation (n = 435), and (3) no ESAS (n = 511). Among patients who were screened for constipation, 17% reported moderate to severe symptoms. Greater constipation severity increased the likelihood of documented assessment (Z = 2.37, p = .018) and intervention (Z = 1.99, p = .048). Overall rates of documented assessment were 36%, with the highest assessment rate in the no ESAS group (χ2 = 9.505, p = .006), a group with the highest proportion of late-stage disease. No difference in the rate of assessment was found between the ESAS and ESAS-C groups. Overall rates for documentation of intervention were low, and did not differ between groups. Specific screening for constipation within an established screening program did not increase the documentation rate for constipation assessment or intervention. The inclusion of specific symptoms in multi-symptom screening initiatives should be carefully evaluated in terms of added value versus patient burden. Care pathways should include guidance on triaging results from multi-symptom screening, and clinicians should pay particular attention to patients who are missed from screening altogether, as they may be the most symptomatic group. |
| Databáze: | OpenAIRE |
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