Prevalence and severity of suffering among patients with advanced cancer

Support Care Cancer. 2012 Dec;20(12):3137-40. doi: 10.1007/s00520-012-1443-6. Epub 2012 Mar 24.

Abstract

Background: Suffering is an expression commonly used to describe distressing experience of cancer patients. Suffering experience among patients with advanced cancer has not been studied before in Saudi Arabia.

Objective: The objective of this study is to determine the pattern of suffering and the feasibility of measuring its severity on a numerical scale for cancer patients attending a palliative care outpatient clinic.

Methods: This is part of a larger survey studying the pattern of symptomatology in an outpatient palliative care clinic. Over a 5-month period, cancer patients attending an outpatient palliative care clinic were requested to rate their suffering as well as 11 listed symptoms on a 0-10 numerical scale.

Results: Of the 124 patients interviewed, 73 (59 %) were females. Only 15 patients (12 %) reported no suffering. For those who were suffering (88 %), the median score is 5. Suffering scores did not differ based on sex, age, or type of cancer. Patients with a Palliative Performance Scale of ≤50 % had significantly higher mean suffering score (6.8) compared to those with better performance status (4.8; P = 0.003). Multivariate analysis resulted in three independent variables showing a significant relationship to suffering score, namely pain (P = 0.018), tiredness (P = 0.022), and depression (P = 0.022).

Conclusion: Patients with advanced cancer were able to easily rate their suffering on a numerical scale. Pain, tiredness, and depression were associated with the suffering scores. Suffering scores might help in tracing the trend of suffering in the individual patient over time.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Depression / epidemiology
  • Depression / psychology
  • Fatigue / epidemiology
  • Fatigue / etiology
  • Fatigue / psychology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasms / complications
  • Neoplasms / epidemiology
  • Neoplasms / psychology*
  • Outpatients / psychology
  • Outpatients / statistics & numerical data
  • Pain / epidemiology
  • Pain / etiology
  • Pain / psychology
  • Palliative Care / psychology*
  • Prevalence
  • Saudi Arabia / epidemiology
  • Severity of Illness Index
  • Stress, Psychological / epidemiology*
  • Stress, Psychological / etiology