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Supportive Care in Cancer
Published in: Supportive Care in Cancer 10/2018

01-10-2018 | Original Article

Predictors of outpatients’ request for palliative care service at a medical oncology clinic of a German comprehensive cancer center

Authors: Mitra Tewes, Teresa Rettler, Nathalie Wolf, Jörg Hense, Martin Schuler, Martin Teufel, Mingo Beckmann

Published in: Supportive Care in Cancer | Issue 10/2018

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Abstract

Purpose

Early integration of palliative care (PC) is recommended. The determination of predictors for patients’ request for PC may guide implementation in clinical practice. Toward this end, we analyzed the symptom burden and distress of cancer patients in outpatient care and examined their need and request for PC.

Methods

Between October 2013 and March 2016, 705 patients receiving outpatient cancer treatment took part in the survey. We used the new MInimal DOcumentation System to detect symptom clusters. Additionally, patients’ request for palliative and psychosocial support was assessed. Groups of patients with PC request were compared to patients without PC request regarding their symptom clusters. Logistic regression analysis was applied to discover significant predictors for the requested inclusion of PC.

Results

A total of 159 patients (25.5%) requested additional support by PC. Moderate and severe tiredness (40.3%), weakness (37.9%), pain (25.0%), loss of appetite (22.3%), and dyspnea (19.1%) were the most frequent symptoms. The group of patients requesting PC differed significantly in terms of pain, nausea, dyspnea, constipation, weakness, loss of appetite, tiredness, depression, and anxiety from patients without request for PC (p < .01). The perceived need for PC was identified by the significant predictors “depression,” “anxiety,” and “weakness” with an explained variance of 22%.

Conclusion

Combining a standardized screening questionnaire and the assessment of patients’ request for PC allows systematic monitoring for patients’ need for PC in a large Medical Oncology clinic. Depression, anxiety, and weakness are predictors of requesting PC service by patients receiving outpatient cancer treatment.
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Metadata
Title
Predictors of outpatients’ request for palliative care service at a medical oncology clinic of a German comprehensive cancer center
Authors
Mitra Tewes
Teresa Rettler
Nathalie Wolf
Jörg Hense
Martin Schuler
Martin Teufel
Mingo Beckmann
Publication date
01-10-2018
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 10/2018
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-018-4245-7

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