Advanced cancer patients' self-assessed physical and emotional problems on admission and discharge from hospital general wards – a questionnaire study

Advanced cancer patients' self-assessed physical and emotional problems on admission and discharge from hospital general wards – a questionnaire study

 (2012) European Journal of Cancer Care

Most cancer patients receiving life-prolonging or palliative treatment are offered non-specialist palliative services. There is a lack of knowledge about their problem profile. The aim of this article is to describe the incidence of patient-reported physical and emotional problems on admission and discharge from general hospital wards and health staff's reported intervention.

A prospective study was undertaken over 12 months, where advanced cancer patients completed a patient questionnaire, EORTC QLQ C15-PAL, on admission (n= 97) and discharge (n= 46). The incidences of the problems were dichotomised in intensity categories. The average number of ‘clinically relevant problems’ on admission was 5 (SD 2) and on discharge 4 (SD 2).

A Wilcoxon signed rank test showed significant change in mean score for six out of nine problem areas, but the majority of the patients did not move to the lower intensity category. The highest concurrence was between patient-reported problems and reported intervention for physical function, pain, constipation and loss of appetite. Palliative cancer patients' self-reported problem profile on admission and discharge from hospital has not previously been described and the results indicate a need to focus on improvements to palliative services and for a special service for pain and constipation that could prevent some admissions.

open access: A person-time analysis of hospital activity among cancer survivors in England - UKPMC Article - UK PubMed Central

Conclusion:

The person-time approach used in this study is more revealing than a simple enumeration of cancer survivors and hospital admissions. Hospital activity among cancer survivors is highest soon after diagnosis. The effect of age on the amount of hospital activity is different for each type of cancer.

...........This paper highlights the significant effect that time since diagnosis has on the average amount of hospitalisation experienced by cancer survivors. The majority of cancer-related admitted hospital episodes of care occurred in the first year following diagnosis (when initial cancer treatment takes place); however, there was also a significant amount of hospital activity in the period 1–5 years after diagnosis, particularly among survivors of colorectal and lung cancers, which is indicative of the ongoing consequences of cancer and its treatment. Other work has shown that the final year before death also contains significant amounts of hospitalisation of cancer survivors (Maddams et al, 2011). These findings help to understand the burden of cancer on the health service, but further work is still required to identify potential areas of unmet needs among cancer survivors.