Department of Palliative Care, The Royal Melbourne Hospital, Parkville, Victoria, Australia
Department of Medicine (RMH), University of Melbourne, Parkville, Victoria, Australia.
BMJ Support Palliat Care. 2022 Dec;12(e6):e792-e797. doi: 10.1136/bmjspcare-2018-001560. Epub 2019 Feb 4.
There is increasing recognition that patients with non-malignant diseases have comparable physical and psychosocial symptom burden to patients with cancer. There is currently limited data directly comparing symptom burden between these patient groups.
To investigate differences in symptom burden between patients with malignant and non-malignant conditions admitted to a palliative care unit (PCU).
A cross-sectional study involving 186 patients admitted to a PCU was undertaken. Patients were dichotomised into malignant or non-malignant disease categories. Symptom burden at admission was assessed using the Symptom Assessment Scale and Palliative Care Problem Severity Score. Group differences in symptoms were analysed using univariate and multivariate approaches.
One hundred patients (53.8%) had cancer, with upper gastrointestinal the most common type (18.0%). Among the 86 patients with non-malignant disease, neurological conditions were most prevalent (40.7%). Patients admitted with non-malignant diseases were older, more functionally impaired and more likely to be deteriorating or terminal. A malignant diagnosis was associated with a higher likelihood of clinician-assessed pain, patient-assessed pain, fatigue, psychological/spiritual symptoms and other symptoms. However, when adjusted for confounders, disease category ceased to be a significant predictor of symptom burden. Younger patients experienced worse pain and patients in terminal phase experienced less symptom burden.
Symptom burden was similar between patients with malignant and non-malignant disease after adjustment for confounders. Further research is needed to understand the palliative care needs of patients with non-malignant disease.
越来越多的人认识到，患有非恶性疾病的患者与癌症患者具有相当的身体和心理社会症状负担。目前，直接比较这两组患者症状负担的数据有限。
调查姑息治疗病房（PCU）收治的恶性和非恶性疾病患者的症状负担差异。
对入住 PCU 的 186 名患者进行了一项横断面研究。患者分为恶性或非恶性疾病类别。入院时的症状负担使用症状评估量表和姑息治疗问题严重程度评分进行评估。使用单变量和多变量方法分析症状的组间差异。
100 名患者（53.8%）患有癌症，最常见的类型是上消化道癌症（18.0%）。在 86 名患有非恶性疾病的患者中，神经科疾病最为常见（40.7%）。患有非恶性疾病的患者年龄较大，功能受损更严重，且更有可能处于恶化或终末期。恶性诊断与更大概率的临床医生评估的疼痛、患者评估的疼痛、疲劳、心理/精神症状和其他症状相关。然而，在调整混杂因素后，疾病类别不再是症状负担的显著预测因素。年轻患者经历更严重的疼痛，处于终末期的患者症状负担较轻。
在调整混杂因素后，恶性和非恶性疾病患者的症状负担相似。需要进一步研究来了解非恶性疾病患者的姑息治疗需求。
