title: Symptoms in the lives of terminal cancer patients: which is the most important?
abstract: OBJECTIVE
  Symptoms other than their primary disease can interfere in the lives of terminal cancer patients. We sought to identify which of these symptoms is most important.
  
  
  METHODS
  We administered a questionnaire, including the M.D. Anderson Symptom Inventory (MDASI), to 142 terminal cancer patients at the National Cancer Center, Korea. The validity of the MDASI was tested by principal-axis factor analysis and Cronbach's alpha coefficient. Stepwise multiple regression analysis was used to determine the symptoms that interfered most in terminal cancer patients' lives.
  
  
  RESULTS
  Factor analysis showed that it was composed of two factors (symptom and interference scales). Cronbach's alpha coefficients of symptom and interference scales were each >0.70. The patients had an average of 11 of 13 symptoms of the MDASI. Pain was the most common and severe, followed by feelings of distress and fatigue. Fatigue was the most highly correlated with interference sum. In stepwise multiple regression analysis, the most interfering symptom was fatigue.
  
  
  CONCLUSIONS
  Although pain was the most common and severe symptom, fatigue was the most important symptom interfering in the lives of terminal cancer patients. In treating terminal cancer patients, healthcare providers should actively intervene to reduce both fatigue and pain.
authors.affiliation: Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, Korea.
authors.forename: Yong Chol
authors.initials: YC
authors.lastname: Kwon
authors.forename: Young Ho
authors.initials: YH
authors.lastname: Yun
authors.forename: Ki Heon
authors.initials: KH
authors.lastname: Lee
authors.forename: Ki Young
authors.initials: KY
authors.lastname: Son
authors.forename: Sang Min
authors.initials: SM
authors.lastname: Park
authors.forename: Yoon Jung
authors.initials: YJ
authors.lastname: Chang
authors.forename: Xin Shelley
authors.initials: XS
authors.lastname: Wang
authors.forename: Tito R
authors.initials: TR
authors.lastname: Mendoza
authors.forename: Charles S
authors.initials: CS
authors.lastname: Cleeland
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005221:Fatigue / Q000175:diagnosis; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000175:diagnosis*; D010146:Pain / Q000175:diagnosis; D011788:Quality of Life; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D013727:Terminal Care