title: The Symptom Experience of Patients With Advanced Pancreatic Cancer: An Integrative Review.
abstract: BACKGROUND
  Pancreatic cancer is a devastating disease with limited treatment options. More than 80% of pancreatic cancers are diagnosed in advanced stages and often have debilitating symptoms, making symptom management paramount, yet the symptom experience of patients with advanced pancreatic cancer (APC) is not well understood.
  
  
  OBJECTIVE
  The purpose of this integrative review is to synthesize the current evidence regarding the symptom experience of patients with APC.
  
  
  METHODS
  An integrative literature review was conducted to identify the patient symptom experience in studies published from 2005 to 2015.
  
  
  RESULTS
  Sixteen studies met the inclusion criteria. All studies used a quantitative approach; 44% were quasi-experimental, 31% were descriptive, and 25% were correlational. Physical symptoms, especially pain, were the primary focus in most studies. Fatigue, loss of appetite, and impaired sense of well-being were prevalent and reported by patients to be of high intensity. Few studies examined psychological symptoms in patients with APC, although anxiety and depression were noted.
  
  
  CONCLUSIONS
  Findings suggest that physical and psychological symptoms are prevalent, some with high intensity. Preselection of symptom inventories limits our ability to fully understand the symptom experience of patients with APC. Future qualitative work is needed to provide a more in-depth understanding of symptoms, especially symptom quality and distress level, from patients' perspectives. More studies are needed to explore psychological symptoms and the interaction of physical and psychological symptoms.
  
  
  CONCLUSIONS
  Findings help healthcare givers to better understand the symptom experience of their APC patients.
authors.affiliation: Author Affiliations: School of Nursing, Indiana University Purdue University at Indianapolis.
authors.forename: Chia-Chun
authors.initials: CC
authors.lastname: Tang
authors.forename: Diane
authors.initials: D
authors.lastname: Von Ah
authors.forename: Janet S
authors.initials: JS
authors.lastname: Fulton
mesh_terms: D006801:Humans; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000473:pathology*; D063189:Symptom Assessment / Q000523:psychology*