title: Medical Oncology Patients: Are They Offered Help and Does It Provide Relief?
abstract: BACKGROUND
  Identifying modifiable gaps in the symptom management pathway, as perceived by patients, is the first step to relieving patient suffering.
  
  
  OBJECTIVE
  The objective is to describe the proportion of patients experiencing treatable cancer-related symptoms who reported 1) a health care provider at the treatment center offered assistance for their symptom, 2) they accepted the assistance offered, and 3) the assistance relieved suffering. Variation in symptom management among treatment centers also was examined.
  
  
  METHODS
  A survey was done with 528 medical oncology outpatients recruited from six treatment centers. Eight items explored management of prevalent, burdensome, and treatable cancer-related symptoms: pain, fatigue, other physical side effects, and emotional distress. Participants were asked about symptom management provided at the clinic from where they were recruited. Questions referred to the last occasion the patient experienced the symptom.
  
  
  RESULTS
  Fewer patients were offered help to relieve fatigue (44%) and emotional distress (57%), than pain (90%) and other physical side effects (84%). In most cases, help was not offered as clinic staff were not aware of the patient's symptom. Although the vast majority of patients accepted the help that was offered, more patients accepted help for physical symptoms (pain, 97%; fatigue, 95%; and other side effects, 98%) than emotional symptoms (87%). When care was provided, most patients experienced at least a little relief from pain (99%), fatigue (94%), and emotional distress (96%). Symptom management did not vary significantly by treatment center (P = 0.073).
  
  
  CONCLUSIONS
  Quality improvement initiatives must focus primarily on improving providers' awareness of their patients' symptoms and ensuring that patients are subsequently offered help.
authors.affiliation: Health Behaviour Research Group, Priority Research Centre for Health Behaviour, University of Newcastle, and Hunter Medical Research Institute, Callaghan, New South Wales, Australia. Electronic address: Alison.Zucca@newcastle.edu.au.
authors.forename: Alison
authors.initials: A
authors.lastname: Zucca
authors.affiliation: Health Behaviour Research Group, Priority Research Centre for Health Behaviour, University of Newcastle, and Hunter Medical Research Institute, Callaghan, New South Wales, Australia.
authors.forename: Rob
authors.initials: R
authors.lastname: Sanson-Fisher
authors.affiliation: Health Behaviour Research Group, Priority Research Centre for Health Behaviour, University of Newcastle, and Hunter Medical Research Institute, Callaghan, New South Wales, Australia.
authors.forename: Amy
authors.initials: A
authors.lastname: Waller
authors.affiliation: Health Behaviour Research Group, Priority Research Centre for Health Behaviour, University of Newcastle, and Hunter Medical Research Institute, Callaghan, New South Wales, Australia.
authors.forename: Mariko
authors.initials: M
authors.lastname: Carey
authors.affiliation: Health Behaviour Research Group, Priority Research Centre for Health Behaviour, University of Newcastle, and Hunter Medical Research Institute, Callaghan, New South Wales, Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Fradgley
authors.affiliation: Health Behaviour Research Group, Priority Research Centre for Health Behaviour, University of Newcastle, and Hunter Medical Research Institute, Callaghan, New South Wales, Australia.
authors.forename: Tim
authors.initials: T
authors.lastname: Regan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia; D005221:Fatigue / Q000503:physiopathology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000379:methods*; D008875:Middle Aged; D009369:Neoplasms / Q000503:physiopathology / Q000628:therapy*; D010045:Outpatients / Q000523:psychology / Q000706:statistics & numerical data; D010146:Pain / Q000503:physiopathology; D059408:Pain Management / Q000379:methods; D010342:Patient Acceptance of Health Care; D011787:Quality of Health Care; D013315:Stress, Psychological / Q000503:physiopathology / Q000628:therapy; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cancer; distress; fatigue; medical oncology; pain; quality of care