Symptom prevalence and changes of symptoms over ten days in hospitalized patients with advanced cancer: a descriptive study.
OBJECTIVE
This prospective study described symptom prevalence and changes of symptoms over ten days in patients with advanced cancer admitted to two Swiss tertiary care hospitals because of symptoms, deterioration of health status, or complications.


METHODS
Prevalence, frequency, severity of and distress from 31 symptoms were assessed repeatedly with the Memorial Symptom Assessment Scale in 103 patients at admission, and on day six (n = 76) and ten (n = 53) of the hospital stay. Repeated measures regression models were used for analysis.


RESULTS
The mean number of symptoms experienced was 13.0 (SD = 6.1) at admission, 9.7 (SD = 5.4) on day six, 9.3 (SD = 4.9) on day ten. Lack of energy was most prevalent (82% of patients) and most frequent, pain was most severe and distressing; symptom scores of all but 4 symptoms (weight loss, "I don't look like myself," vomiting, itching) were >2 on a scale from 0 to 4. Over time, the average number of symptoms decreased significantly for the whole group (P < .0001) and for patients discharged after day six (P = .006), but not for patients dropping out after day six due to worsening health status (P = .78). Individual trajectories showed that symptom prevalence varied greatly within and among patients.


CONCLUSIONS
High symptom prevalence at admission, identification of areas in symptom management with the potential for improvement, and wide variability in symptom prevalence among patients call for comprehensive symptom assessment and individual treatment, especially in patients with a worsening health status.
Spichiger
Elisabeth
E
Institute of Nursing Science, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland. Elisabeth.spichiger@unibas.ch
Müller-Fröhlich
Christa
C
Denhaerynck
Kris
K
Stoll
Hansruedi
H
Hantikainen
Virpi
V
Dodd
Marylin
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology; D005221:Fatigue / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009369:Neoplasms / Q000473:pathology* / Q000523:psychology / Q000628:therapy*; D009730:Nursing Assessment; D010146:Pain / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data; D015995:Prevalence; D011446:Prospective Studies; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D013557:Switzerland; D013997:Time Factors; D055815:Young Adult