Symptom assessment in advanced palliative home care for cancer patients using the ESAS: clinical aspects.
Four hundred and thirty-one cancer patients were assessed with the ESAS and a VAS-QoL at admission to Hospital-based home care (HBHC) and subsequently.


RESULTS
Pain and nausea were well-controlled (mean 2.5 and 1.8) whereas patients were less satisfied with appetite, activity and sense of well-being. Dyspnoea and anxiety (lung cancer, p<0.001 and p<0.01) and pain (prostate cancer, p<0.01), were related to diagnosis while activity, drowsiness, appetite and well-being to survival (p<0.05 to p<0.001). The correlations between individual symptoms and well-being were low (0.2-0.5), whereas the correlation between well-being and the Symptom Distress Score (SDS) was 0.76. "Well-being" was a better word to use than QoL.


CONCLUSIONS
ESAS is useful in HBHC and data show that symptoms other than merely pain and nausea are of importance. As the global measurement (one VAS) of well-being has a high correlation with SDS, this single measurement may be clinically adequate for quality assurance of symptom control in dying cancer patients.
Heedman
P A
PA
Palliative Advisory Team, Linköping University Hospital, Sweden. per-anders.heedman@lio.se
Strang
P
P
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D018575:Home Care Services, Hospital-Based; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000628:therapy*; D010147:Pain Measurement; D010166:Palliative Care / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D011788:Quality of Life; D012720:Severity of Illness Index; D012737:Sex Factors