[Symptoms assessment in cancer patients on admission to a hospital].
BACKGROUND
Cancer patients frequently receive inadequate pain relief. One potential explanation for treatment failure is that pain and other symptoms are not adequately assessed.


METHODS
We included 201 cancer patients using morphine for pain control. We registered if and how pain and adverse symptoms were noted in the patient records at admission. The records were compared to patients' self-reports of pain.


RESULTS
Notes on pain were taken for 90% of the patients. Physicians took notes on the presence of pain more often than nurses, but nurses used some form of systematic pain rating more frequently than did physicians. Bowel function was noted in 81%, sedation and nausea in about one third of the cases. Most patients for whom pain was not noted had low self-reported pain intensity.


CONCLUSIONS
Physicians and nurses assess pain in the majority of admissions of patients with cancer and ongoing treatment with morphine, but potential adverse effects are more infrequent addressed. Standardized and reproducible methods for assessing symptom intensity are seldom used. This study indicates that standardized note-taking of pain and other adverse symptoms should be included in cancer patients' admission records.
Seland
Mette
M
Institutt for kreftforskning og molekylaermedisin, Avdeling for kreft og hudsykdommer, St. Olavs Hospital.
Kaasa
Stein
S
Klepstad
Pål
P
D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects; D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage / Q000009:adverse effects; D009369:Neoplasms / Q000175:diagnosis* / Q000188:drug therapy; D009726:Nurses; D010146:Pain / Q000175:diagnosis* / Q000188:drug therapy; D010147:Pain Measurement / Q000379:methods / Q000592:standards; D010343:Patient Admission; D010820:Physicians
D000701:Analgesics, Opioid; D009020:Morphine