Predictors of high symptom burden in gynecologic oncology outpatients: Who should be referred to outpatient palliative care?
| Autor: | A. Sherman, John K. Chan, Michael W. Rabow, Lee-may Chen, Rachel Ruskin, Carolyn Lefkowits, Tuyen K. Kiet |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
Palliative care Genital Neoplasms Female Gynecologic oncology Ambulatory care Internal medicine Outpatients Ambulatory Care medicine Humans Referral and Consultation Depression (differential diagnoses) Aged Retrospective Studies business.industry Data Collection Medical record Palliative Care Chronic pain Obstetrics and Gynecology Retrospective cohort study Continuity of Patient Care Middle Aged medicine.disease Oncology Physical therapy Anxiety Female Symptom Assessment medicine.symptom business |
| Zdroj: | Gynecologic Oncology. 132:698-702 |
| ISSN: | 0090-8258 |
| Popis: | Objective To characterize symptom prevalence in gynecologic oncology outpatients and identify predictors of high symptom burden. Methods We performed a retrospective analysis of a convenience sample of symptom surveys from gynecologic oncology patients at a single cancer center over a 20-month period. The survey was based on the Edmonton Symptom Assessment System (ESAS), and assessed pain, depression, anxiety, fatigue and well-being. Information on demographics, disease, treatment and history of chronic pain, depression or anxiety was abstracted from medical records. Data was analyzed with descriptive and t-test statistics. Results We analyzed 305 surveys from unique patients. Symptom prevalence (severity score > 0/10) ranged from 60.1% (pain) to 79.7% (fatigue). Prevalence of moderate to severe symptoms (score ≥ 4/10) ranged from 32% (pain) to 47% (fatigue). There were no differences in symptom burden by site or stage of cancer. Patients with no active disease (38%) were less symptomatic. There was a trend toward higher symptom burden in patients younger than 50 years. There was higher symptom burden in patients receiving cancer treatment or with a pre-existing history of pain, anxiety or depression. Patients who expressed an interest in being seen by a symptom management service also had higher symptom burden. Conclusions Gynecologic oncology outpatients have a high symptom burden regardless of stage and site of cancer. Patients who are young, on treatment or have a history of chronic pain, depression or anxiety have a higher symptom burden. Consideration should be given to targeting these patients for outpatient palliative care services. |
| Databáze: | OpenAIRE |
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