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Characterizing distress, the 6th vital sign, in an oncology pain clinic
1Department of Psychosocial Resources, Tom Baker Cancer Centre, Calgary, AB. amy.waller@albertahealthservices.ca
Context:
The delineation of populations of cancer patients with complex symptoms can inform the planning and delivery of supportive care services.
Objectives:
We explored the physical, psychosocial, and practical concerns experienced by patients attending an ambulatory oncology symptom control clinic.
Methods:
Patients attending a Pain Clinic at a large tertiary cancer centre were invited to complete screening measures assessing distress, pain, fatigue, anxiety, depression, and practical and psychosocial problems. A matched sample of patients who did not attend the Pain Clinic were selected as a comparison group.
Results:
Of all eligible Pain Clinic patients, 46 (77%) completed the measures; so did 46 comparison group patients. The percentages of patients reporting distress (78.3%), pain (93.5%), and fatigue (93.5%) were higher among Pain Clinic patients than among the comparison patients. A higher percentage of Pain Clinic patients also reported multiple, severe, concurrent symptoms: 87% scored 7 or higher in at least one of the pain, fatigue, or distress scales, and 30.4% of the patients scored 7 or higher on all three. The most common problem areas were feeling a burden to others, trouble talking with friends and family, spirituality, and sleep difficulties.
Conclusions:
Higher levels of multiple, concurrent symptoms and psychosocial problems were found in Pain Clinic patients than in a group of patients who did not attend the Pain Clinic. Routine screening and triaging of cancer patients using a comprehensive and standardized panel of questions can facilitate symptom assessment and management, and can inform program planning.
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