Modonesi Caterina, Scarpi Emanuela, Maltoni Marco, Derni Stefania, Fabbri Laura, Martini Francesca, Sansoni Elisabetta, Amadori Dino
Palliative Care Unit, Department of Medical Oncology, Forlimpopoli Hospital, Italy.
J Pain Symptom Manage. 2005 Oct;30(4):367-73. doi: 10.1016/j.jpainsymman.2005.04.007.
The aim of the present study was to evaluate the impact of palliative care on patients' symptoms, using the Edmonton Symptom Assessment System (ESAS) to measure symptom intensity at the time of admission and variations registered during the first 7 days' hospitalization. Three hundred fourteen patients were admitted to the unit during its first year of activity. Of these, 162 patients (51.6%) completed, 62 (19.7%) partially completed, and 90 (28.7%) did not complete the ESAS. The mean (+/-SD) value of the Symptom Distress Score (SDS) (sum of the values of the different symptoms) for the 162 evaluable patients on Day 1 was 33.93 (+/-16.24). On Day 7 the mean was 28.14 (+/-15.11) (ANOVA for repeated measurements, P < 0.0001). ESAS values for patients with moderate-severe symptom intensity (average values Day 1-Day 7 and P value, ANOVA for repeated measurements) were as follows: pain (7.12-4.23, P < 0.0001), fatigue (7.46-5.68, P < 0.0001), nausea (7.12-1.96, P < 0.0001), depression (7.26-5.28, P < 0.0001), anxiety (7.13-5.14, P < 0.0001), drowsiness (7.42-6.40, P = 0.002), anorexia (7.33-4.33, P < 0.0001), well-being (6.83-3.85, P < 0.0001), and dyspnea (7.08-3.86, P < 0.0001). These data seem to indicate that the patients who benefit most from inpatient palliative care are those with the most complex symptomatology.
本研究的目的是评估姑息治疗对患者症状的影响，使用埃德蒙顿症状评估系统（ESAS）来测量入院时的症状强度以及住院前7天记录的变化情况。该科室在运营的第一年共收治了314名患者。其中，162名患者（51.6%）完成了评估，62名患者（19.7%）部分完成了评估，90名患者（28.7%）未完成ESAS评估。162名可评估患者在第1天的症状困扰评分（SDS）（不同症状评分之和）的平均值（±标准差）为33.93（±16.24）。第7天的平均值为28.14（±15.11）（重复测量方差分析，P<0.0001）。中度至重度症状强度患者的ESAS值（第1天至第7天的平均值及P值，重复测量方差分析）如下：疼痛（7.12 - 4.23，P<0.0001）、疲劳（7.46 - 5.68，P<0.0001）、恶心（7.12 - 1.96，P<0.0001）、抑郁（7.26 - 5.28，P<0.0001）、焦虑（7.13 - 5.14，P<0.0001）、嗜睡（7.42 - 6.40，P = 0.002）、厌食（7.33 - 4.33，P<0.0001）、幸福感（6.83 - 3.85，P<0.0001）和呼吸困难（7.08 - 3.86，P<0.000作）。这些数据似乎表明，从住院姑息治疗中受益最大的患者是那些症状最复杂的患者。
