Mustafa Süren1, Serkan Doğru2, Yalçın Önder3, Nagihan Yıldız Çeltek4, İsmail Okan5, Rıza Çıtıl3, Serkan Karaman2, Nurşah Başol6. 1. Department of Anesthesiology and Reanimation, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey. mustafasuren@yahoo.com. 2. Department of Anesthesiology and Reanimation, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey. 3. Department of Public Health, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey. 4. Department of Family Health, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey. 5. Department of General Surgery, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey. 6. Department of Emergency Medicine, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey.
Abstract
OBJECTIVES: Palliative care has been developing rapidly throughout the world. A substantial number of palliative care patients are advanced cancer patients. Terminal cancer patients suffer from groups of symptoms called symptom clusters, rather than from individual independent symptoms. The aim of this study is to evaluate the symptoms of terminal cancer patients retrospectively and to present the symptom clusters of these patients. METHODS: After ethical approval was obtained, a total of 113 (74 female, 39 male) patients with the diagnosis of the terminal stage cancer were retrospectively evaluated in Gaziosmanpasa University, Department of Anesthesiology and Reanimation between January 2011 and January 2013. Patient records were used to obtain medical history, physical examination findings, patient complaints, accompanying persons, primary cancer site, and metastasis sites. Symptoms such as fatigue, pain, vomiting, loss of appetite,insomnia, constipation, cough and dyspnea were assessed with the Edmonton Symptom Assessment System scale (0: None, 10: Worst possible). The symptom clusters were constructed using hierarchical symptom cluster analysis. RESULTS: The mean age was 64.51 ± 11.38 years. Patients were referred to our outpatient clinic from Departments of General Surgery, Emergency Medicine, Urology, Oncology, Ear-Nose-Throat, Thoracic Surgery, Internal Medicine and Neurosurgery. Fatigue was the most-detected symptom (98.2%). Three symptom clusters were identified: nausea-vomiting-loss of appetite-constipation, dyspnea-cough, and fatigue-pain-insomnia. CONCLUSION: Although palliative cancer patients were referred mainly with the symptom of pain, at least three symptom clusters were detected. The management of terminal stage cancer patients should focus on symptom clusters rather than individual symptoms.
OBJECTIVES: Palliative care has been developing rapidly throughout the world. A substantial number of palliative care patients are advanced cancerpatients. Terminal cancerpatients suffer from groups of symptoms called symptom clusters, rather than from individual independent symptoms. The aim of this study is to evaluate the symptoms of terminal cancerpatients retrospectively and to present the symptom clusters of these patients. METHODS: After ethical approval was obtained, a total of 113 (74 female, 39 male) patients with the diagnosis of the terminal stage cancer were retrospectively evaluated in Gaziosmanpasa University, Department of Anesthesiology and Reanimation between January 2011 and January 2013. Patient records were used to obtain medical history, physical examination findings, patient complaints, accompanying persons, primary cancer site, and metastasis sites. Symptoms such as fatigue, pain, vomiting, loss of appetite,insomnia, constipation, cough and dyspnea were assessed with the Edmonton Symptom Assessment System scale (0: None, 10: Worst possible). The symptom clusters were constructed using hierarchical symptom cluster analysis. RESULTS: The mean age was 64.51 ± 11.38 years. Patients were referred to our outpatient clinic from Departments of General Surgery, Emergency Medicine, Urology, Oncology, Ear-Nose-Throat, Thoracic Surgery, Internal Medicine and Neurosurgery. Fatigue was the most-detected symptom (98.2%). Three symptom clusters were identified: nausea-vomiting-loss of appetite-constipation, dyspnea-cough, and fatigue-pain-insomnia. CONCLUSION: Although palliative cancerpatients were referred mainly with the symptom of pain, at least three symptom clusters were detected. The management of terminal stage cancerpatients should focus on symptom clusters rather than individual symptoms.
Authors: Oscar Corli; Giacomo Pellegrini; Cristina Bosetti; Luca Riva; Matteo Crippa; Emanuele Amodio; Gianlorenzo Scaccabarozzi Journal: Int J Environ Res Public Health Date: 2020-11-14 Impact factor: 3.390