Symptom patterns of advanced cancer patients in a palliative care unit
Journal
Palliative Medicine
Journal Volume
20
Journal Issue
6
Pages
617-622
Date Issued
2006
Author(s)
Abstract
This study involved longitudinal evaluations of symptom severity and describes the symptom patterns of 77 terminal cancer patients (median age: 62 years; 61% female), selected from 537 consecutive patients admitted to the Palliative Care Unit of the National Taiwan University Hospital. The most common primary cancer sites in these patients were lung (23.4%), liver (15.6%), and stomach (13%). Nineteen physical and psychological symptoms were assessed using different scales. The median number of symptoms was 11 (range: 1-18) on admission, among which weakness, fatigue, anorexia, pain, and depression were the most common. A comparison of the initial symptom severity scores with those at one week after admission and two days before death suggested six symptom change patterns: A: continuous static (restless/heat, abdominal fullness, constipation, dizziness, and insomnia); B: static-increase (fatigue, weakness, nausea/vomiting, taste alteration, dysphagia, diarrhea, dry mouth, and night sweats); C: decrease-static (pain and depression); D: decrease-increase (anorexia and dyspnea); E: static-decrease (aggression); and F: gradually decrease (anxiety). These six symptom patterns can be divided into two categories on the basis of the relative severity of symptoms between one week after admission and two days before death. The first category included patterns A, C, E and F, and the symptoms improved with palliative care. However, the symptoms in the second category (patterns B and D), which were associated with the anorexia-cachexia syndrome and dyspnea, did not show improvement. As symptom management is an essential component of palliative care, holistic care, which encompasses physical, psychosocial and spiritual aspects, represents a rational approach for the relief of these incurable symptoms at the end stage of life for these patients. ? 2006 SAGE Publications.
SDGs
Other Subjects
adolescent; adult; advanced cancer; aged; aggression; anorexia; anxiety; article; cachexia; cancer fatigue; cancer pain; cancer palliative therapy; cancer patient; constipation; controlled study; depression; diarrhea; disease severity; dizziness; dysphagia; dyspnea; epigastric fullness; female; holistic care; human; insomnia; length of stay; liver cancer; longitudinal study; lung cancer; major clinical study; male; mental disease; nausea; night sweat; oncology ward; physical disease; poor general condition; primary tumor; psychosocial care; restlessness; spiritual care; stomach cancer; symptomatology; taste disorder; terminally ill patient; time of death; vomiting; weakness; xerostomia; hospitalization; middle aged; neoplasm; organization and management; palliative therapy; psychological aspect; Taiwan; Adolescent; Adult; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Neoplasms; Palliative Care; Severity of Illness Index; Taiwan
Type
journal article