title: Symptom frequency, severity, and quality of life among persons with three disease trajectories: cancer, ALS, and CHF.
abstract: OBJECTIVE
  National reports on end-of-life symptom management reveal a gap in the evidence regarding symptoms other than pain and studies of diseases other than cancer. This study examines the frequency and severity of symptoms and quality of life (QOL) in persons with advanced cancer, amyotrophic lateral sclerosis (ALS), and congestive heart failure (CHF).
  
  
  METHODS
  The present study is a cross-sectional examination of symptoms and QOL measured using the McGill QOL Questionnaire, among 147 participants.
  
  
  RESULTS
  Forty one percent of participants had advanced cancer, 22% had ALS, and 37% had advanced CHF. A total of 266 symptoms were reported, with the common symptom categories being discomfort/pain, weakness/fatigue/sleep, and respiratory. Participants with CHF had the highest mean symptom severity and the lowest QOL.
  
  
  CONCLUSIONS
  Clinicians should be aware and attentive for symptoms other than pain in patients with advanced illness. Studies on diseases other than cancer, such as CHF and ALS, are important to improve symptom management in all disease groups.
authors.affiliation: Johns Hopkins University School of Nursing, Baltimore, MD 21205, USA. Electronic address: jxu32@jhu.edu.
authors.forename: Jiayun
authors.initials: J
authors.lastname: Xu
authors.affiliation: Johns Hopkins University School of Nursing, Baltimore, MD 21205, USA. Electronic address: mnolan3@jhu.edu.
authors.forename: Marie T
authors.initials: MT
authors.lastname: Nolan
authors.affiliation: Johns Hopkins University School of Nursing, Baltimore, MD 21205, USA. Electronic address: kgriff12@jhu.edu.
authors.forename: Katherine
authors.initials: K
authors.lastname: Heinze
authors.affiliation: Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA. Electronic address: gyenoky1@jhu.edu.
authors.forename: Gayane
authors.initials: G
authors.lastname: Yenokyan
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA. Electronic address: mthughes@jhmi.edu.
authors.forename: Mark T
authors.initials: MT
authors.lastname: Hughes
authors.affiliation: The University of Chicago Medicine, Chicago, IL 60637, USA. Electronic address: jjohnso3@medicine.bsd.uchicago.edu.
authors.forename: Julie
authors.initials: J
authors.lastname: Johnson
authors.affiliation: Johns Hopkins University School of Nursing, Baltimore, MD 21205, USA. Electronic address: jkub1@jhu.edu.
authors.forename: Joan
authors.initials: J
authors.lastname: Kub
authors.affiliation: Johns Hopkins University School of Nursing, Baltimore, MD 21205, USA. Electronic address: ctudor2@jhu.edu.
authors.forename: Carrie
authors.initials: C
authors.lastname: Tudor
authors.affiliation: The University of Chicago Medicine, Chicago, IL 60637, USA. Electronic address: dsulmasy@bsd.uchicago.edu.
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Sulmasy
authors.affiliation: Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA. Electronic address: LLEHMANN1@PARTNERS.ORG.
authors.forename: Lisa Soleymani
authors.initials: LS
authors.lastname: Lehmann
authors.affiliation: Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA. Electronic address: jgallo@jhsph.edu.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Gallo
authors.affiliation: Johns Hopkins University School of Nursing, Baltimore, MD 21205, USA. Electronic address: felicia.rockko@gmail.com.
authors.forename: Felicia
authors.initials: F
authors.lastname: Rockko
authors.affiliation: Johns Hopkins University School of Nursing, Baltimore, MD 21205, USA. Electronic address: lee@son.umaryland.edu.
authors.forename: Mei Ching
authors.initials: MC
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000690:Amyotrophic Lateral Sclerosis / Q000503:physiopathology*; D005260:Female; D006333:Heart Failure / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000503:physiopathology*; D011788:Quality of Life; D012720:Severity of Illness Index
keywords: Chronic disease; End of life; Quality of life; Symptoms