ASSESSMENT OF THE PALLIATIVE CARE AND DEPRESSION SYMPTOMS AMONG CANCER PATIENTS: A CROSS-SECTIONAL STUDY
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Date
2022-02-24
Authors
Battat, Maher
Journal Title
Journal ISSN
Volume Title
Publisher
جامعة النجاح الوطنية
Abstract
Background: Palliative care is critical for redundancy in cancer patients looking for quality of life improvement; symptom assessment should be incorporated in clinical practice routines at all stages of cancer. The Edmonton Symptom Assessment System (ESAS) used to rate the intensity of ten symptom assessment that has been designed and validated for cancer patients in a variety of languages and cultures. On the other hand, Beck’s Depression Inventory (BDI II) used to assess depression symptoms and depression severity, which is one of the palliative care symptoms among cancer patients that can be assessed by ESAS. Therefore, the study aims to assess cancer patients reported symptoms focusing on depression using ESAS scores and the BDI II scale to identify patients who would benefit from palliative care that can improve the integration of palliative care into standard oncology care at An-Najah National University Hospital (NNUH).
Methods: A cross-sectional study was selected for 271 cancer patients by using a convenience sampling method at NNUH. Demographic, clinical, and lifestyle characteristics are described. The results of the moderate to severe symptoms (score >4) reported by the patients were obtained using the ESAS. The BDI II scale was used to detect the level of depression.
Results: The survey consisted of 271 patients, with a response rate of 95%. The average age of the patients was 47±17.7 years, with a range of 18 to 84 years. The male to female ratio was around 1:1 and 59.4 % of the patients were outpatients, and 153 (56.5 %) had hematologic malignancies. Fatigue (62.7 %) and drowsiness (61.6 %) were the most common moderate to severe symptoms in ESAS, also Pain (54.6 %), nausea (40.2 %), , lack of appetite (55.0 %), Sortness Of Breath (SOB) (28.5%), depression (40.6 %), anxiety (47.2 %), and poor well-being (56.5 %) were reported. In terms of BDI II depression scores, the majority of cancer patients (n=104, 38.4%) had minimal depression, while 22.5 %, 22.1 %, and 17.0 % had mild, moderate, and severe depression, respectively, with statistically significant associations between all symptoms of ESAS symptoms and BDI II scores.
Conclusions: Fatigue and drowsiness were the most reported symptoms according to the ESAS scale among cancer patients, while depression ranged from minimal to severe according to BDI II mostly minimal depression, whereas moderate to severe depression symptom was reported on cancer patients using ESAS. ESAS and BDI II were functional tools for depression symptoms among cancer patients to establish palliative care services.
Implications: ESAS is an applicable tool for assessing palliative care symptoms among cancer patients at NNUH to improve their quality of life.
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Keywords
Palliative Care; Palliative Care symptoms; Depression symptoms; ESAS; Palestine; Cancer patients; Oncology