Self-assessment in cancer patients referred to palliative care: a study of feasibility and symptom epidemiology.
BACKGROUND
Research in palliative care is considered difficult due to the poor health of patients. However, patient-provided data are essential for a thorough description of patient symptomatology and for the evaluation of care.


METHODS
The authors examined the feasibility of a questionnaire-based study using the European Organization for Research and Treatment of Cancer quality-of-life instrument EORTC QLQ-C30, the Edmonton Symptom Assessment System (ESAS), and the Hospital Anxiety and Depression Scale (HADS) in cancer patients who were receiving palliative care. This report describes the symptomatology of participating patients and examines differences in symptomatology between patients in three palliative care functions: inpatient, outpatient, and palliative home care.


RESULTS
Of 267 eligible patients who were referred to a department of palliative medicine, initial self-assessment questionnaires were obtained from 176 patients (65.9%). The 91 nonparticipants were older and had lower Karnofsky Performance status (KPS) values than the participants. Almost all participating patients suffered from impaired role function and physical function and had high levels of pain, fatigue, and other symptoms. According to the HADS, 47% of patients suffered from depression. Outpatients had better scores than inpatients and patients in palliative home care for physical function, role function, cognitive function, depression, and inactivity.


CONCLUSIONS
It is possible to carry out a questionnaire-based study of symptomatology in consecutive cancer patients in palliative care, achieving rather complete data from the participants. The symptomatology in these patients was very pronounced. The questionnaires were able to detect clinically important differences between places of service.
Strömgren
Annette S
AS
Department of Palliative Medicine, Bispebjerg Hospital, Copenhagen, Denmark. as06@bbh.hosp.dk
Goldschmidt
Dorthe
D
Groenvold
Mogens
M
Petersen
Morten Aa
MA
Jensen
Pernille T
PT
Pedersen
Lise
L
Hoermann
Linda
L
Helleberg
Carsten
C
Sjogren
Per
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003718:Denmark / Q000453:epidemiology; D005240:Feasibility Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000628:therapy*; D010166:Palliative Care / Q000592:standards*; D011788:Quality of Life; D012647:Self-Assessment; D011795:Surveys and Questionnaires