Van Lancker Aurélie, Velghe Anja, Van Hecke Ann, Verbrugghe Mathieu, Van Den Noortgate Nele, Grypdonck Mieke, Verhaeghe Sofie, Bekkering Geertruida, Beeckman Dimitri
Nursing Science, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
Department of Geriatric Medicine, University Hospital Ghent, Ghent, Belgium.
J Pain Symptom Manage. 2014 Jan;47(1):90-104. doi: 10.1016/j.jpainsymman.2013.02.016. Epub 2013 Jun 10.
Symptom control is an essential part of palliative care and important to achieve optimal quality of life. Studies showed that patients with all types of advanced cancer suffer from diverse and often severe symptoms. Research focusing on older persons is scarce because this group is often excluded from studies. Consequently, it is unclear which symptoms older palliative care patients with cancer experience and what is the prevalence of these symptoms. To date, no systematic review has been performed on the prevalence of symptoms in older cancer patients receiving palliative care.
The objective of this systematic review was to search and synthesize the prevalence figures of symptoms in older palliative care patients with cancer.
A systematic search through multiple databases and other sources was conducted from 2002 until April 2012. The methodological quality was evaluated. All steps were performed by two independent reviewers. A meta-analysis was performed to pool the prevalence of symptoms.
Seventeen studies were included in this systematic review. Thirty-two symptoms were identified. The prevalence of these symptoms ranged from 3.5% to 77.8%. The most prevalent symptoms were fatigue, excretory symptoms, urinary incontinence, asthenia, pain, constipation, and anxiety and occurred in at least 50% of patients.
There is a high degree of uncertainty about the reported symptom prevalence because of small sample sizes, high heterogeneity among studies, and the extent of instrument validation. Research based on rigorous methods is needed to allow more conclusive results.
症状控制是姑息治疗的重要组成部分，对于实现最佳生活质量至关重要。研究表明，所有类型的晚期癌症患者都会出现各种各样且往往很严重的症状。针对老年人的研究很少，因为这个群体通常被排除在研究之外。因此，尚不清楚老年癌症姑息治疗患者会出现哪些症状以及这些症状的患病率是多少。迄今为止，尚未对接受姑息治疗的老年癌症患者的症状患病率进行系统评价。
本系统评价的目的是检索并综合老年癌症姑息治疗患者症状的患病率数据。
从2002年至2012年4月，通过多个数据库和其他来源进行了系统检索。对方法学质量进行了评估。所有步骤均由两名独立的评审员完成。进行了荟萃分析以汇总症状的患病率。
本系统评价纳入了17项研究。确定了32种症状。这些症状的患病率从3.5%到77.8%不等。最常见的症状是疲劳、排泄症状、尿失禁、乏力、疼痛、便秘以及焦虑，至少50%的患者出现这些症状。
由于样本量小、研究间异质性高以及工具验证的程度，所报告的症状患病率存在高度不确定性。需要开展基于严格方法的研究以得出更具结论性的结果。
