Hospice patients' and nurses' perceptions of self-care deficits based on symptom experience

Although the relief and/or control of physically, emotionally, and spiritually distressing symptoms are the hallmarks of hospice care, accurate assessment of the individual's unique and often rapidly changing symptom experience is lacking. The purpose of this descriptive, correlational study was to assess and quantify hospice patients' perceptions of their symptom experiences and those of the hospice nurse assessing them. A convenience sample of 53 hospice patients (32 males, 21 females), with a mean age of 69 years, from a large midwestern home-based hospice completed the Adapted Symptom Distress Scale Form 2 (ASDS-2) at admission, and at 2 and 4 weeks after admission. The Hospice Admission Intake was completed at admission. Individual hospice nurses completed the ASDS-2 within 24 hours of their hands-on assessment, in addition to the demographic characteristics profile. Findings indicated an improvement in symptom experience, distress, and occurrence scores from admission to week 2, and in the symptom experience and distress scores from admission to week 4. Hospice nurses tended to give higher symptom experience scores than the patients gave to themselves. These findings demonstrate the importance of obtaining information about symptom experience from the patient as well as the nurse.