Pain intensity, quality of life, quality of palliative care, and satisfaction in outpatients with metastatic or recurrent cancer: a Japanese, nationwide, region-based, multicenter survey

J Pain Symptom Manage. 2012 Mar;43(3):503-14. doi: 10.1016/j.jpainsymman.2011.04.025.

Abstract

Context: Increasing numbers of patients with advanced cancer are receiving anticancer and/or palliative treatment in outpatient settings, and palliative care for outpatients with advanced cancer is being recognized as one of the most important areas for comprehensive cancer treatment.

Objectives: The aim of this study was to evaluate pain intensity, quality of life, quality of palliative care, and satisfaction reported by outpatients with advanced cancer.

Methods: Questionnaires were sent to 1493 consecutive outpatients with metastatic or recurrent cancer from four regions in Japan; 859 responses were analyzed (58%). Questionnaires included the Brief Pain Inventory, Good Death Inventory, Care Evaluation Scale, and a six-point satisfaction scale.

Results: Approximately 20% of the patients reported moderate to severe pain. Whereas more than 70% agreed or strongly agreed with "good relationship with medical staff" and "being respected as an individual," less than 60% agreed or strongly agreed with "free from physical distress," "free from emotional distress," "maintaining hope," and "fulfillment at life's completion"; 54% reported some agreement with "feel a burden to others." About 20% reported that improvement is necessary in physical care by physicians, physical care by nurses, psycho-existential care, help with decision making, and coordination/consistency of care; 13% reported some levels of dissatisfaction.

Conclusion: A considerable number of outpatients with metastatic or recurrent cancer experienced pain, physical symptoms, emotional distress, and existential suffering, and advocated improvements in palliative care across multiple areas.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cross-Sectional Studies
  • Death
  • Female
  • Health Care Surveys
  • Humans
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Neoplasms / complications*
  • Neoplasms / psychology*
  • Nurse-Patient Relations
  • Outpatients
  • Pain / psychology*
  • Pain Measurement*
  • Palliative Care / standards*
  • Patient Satisfaction*
  • Physician-Patient Relations
  • Quality of Life*
  • Recurrence
  • Resuscitation Orders
  • Socioeconomic Factors
  • Surveys and Questionnaires