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Aim To increase the knowledge of the frequency and intensity of symptoms and the treatment interventions in older palliative cancer patients. Background Research on symptoms and the treatment modalities in older palliative cancer patients is scarce. Insight into these aspects is needed to enable healthcare professionals to alleviate the burden. Design A cross-sectional study. Methods Four hundred hospitalized older palliative cancer patients participated in the study between March 2013 - February 2015. Two validated instruments were used to assess 40 symptoms in multiple domains and collect data on the treatment modalities in older palliative cancer patients. Results Patients reported on average approximately 14 symptoms. Dry mouth, physical fatigue, lack of energy, lack of appetite and difficulty moving outside were the most prevalent. Psychological pain, psychological fatigue, lack of willpower, lack of energy and physical fatigue were reported as intensive. On average, 5·15 disciplines were consulted per patient. Few patients were referred to a palliative support team, spiritual consultant or psychologist. Patients received a variety of interventions to increase life expectancy and alleviate symptoms and the side effects of treatment. The occurrence of symptoms was associated with different clinical and treatment variables such as having a geriatric risk profile. Conclusions Older patients receiving palliative cancer care are confronted with multiple symptoms. Psychological symptoms are more often reported as intensive. Greater attention should be given to the early referral of patients to palliative care teams, assessment and management of multiple symptoms, particularly psychological symptoms. [ABSTRACT FROM AUTHOR]

Background Accurate detection of symptoms is essential in palliative care. Identification of clustering of symptom is valuable to develop target interventions. This area is largely understudied in older palliative cancer patients. Objectives To identify symptom clustering in older palliative cancer patients, and patient groups based on the clustering of symptoms, and to evaluate the difference in functional dependence and experiencing life as not meaningful between the identified patient groups. Design A cross-sectional study. Setting Geriatric and non-geriatric wards of seven acute care hospitals. Participants 400 palliative cancer patients aged 65 years and older. Methods Symptoms were collected using a validated instrument which assesses physical, psychological, functional, social, and existential symptoms by means of a structured interview with a researcher. An agglomerative hierarchical clustering analysis was used to analyse the data. Results The cluster analysis revealed five groups of symptoms: (1) urological and gastrointestinal symptoms, and their treatment complications, (2) psychological and existential symptoms, (3) pain, constipation, sleeplessness and airway problems, (4) functionality problems, and (5) fatigue-related symptoms. Three patient groups were identified: (1) symptom-free group, (2) physical discomfort group, and (3) physical and psychological discomfort group. In the last group, significant more patients had a geriatric risk profile and less of them received chemotherapy. Patients in this group were more often functionally dependent and experienced their life as not meaningful. Conclusion Five groups of symptoms were identified. Three patient groups were identified which reported different levels of functionality and experiencing life as meaningful. Healthcare professionals should be triggered to detect symptom clusters and be alert to the presence of the other symptoms in the cluster when identifying one symptom. They should also be alert to patients with a geriatric risk profile because of their higher risk of experiencing physical and psychological symptoms and the influence these symptoms have on being functionally dependent and experiencing life as not meaningful. [ABSTRACT FROM AUTHOR]

Purpose/Objectives: To evaluate the level of agreement of symptom assessment among older a dult palliative patients with cancer, nurses, and patients' proxies. Design: A cross-sectional study. Setting: Two general hospitals in Flanders, Belgium. Sample: 120 palliative patients with cancer, aged 65 years and older. Methods: A validated 3 6 -item instrument developed to assess physical, psychological, functional, social, and existential symptoms in older palliative patients w ith cancer was independently completed by patients, the nurses, and proxies. Main Research Variables: Frequency and intensity of 36 symptoms. Findings: The study indicates that nurses and proxies tend to underestimate physical and social symptoms and over estimate psychological, functional, and existential symptoms. Agreement scores between patients and nurses and patients and proxies were only significantly different in 39% and 20% of the cases, respectively. Higher intraclass correlation coefficients were measured between patients and proxies compared to patients and nurses. Agreement was associated with demographic and clinical factors, such as gender and prognosis. Conclusions: This study indicates discrepancies among patient, nurse, and proxy in the assessment of symptoms. Implications for Nursing: Patients should be encouraged to report their true experiences. Nurses and proxies should be taught to recognize and assess symptoms and to communicate about them with patients. [ABSTRACT FROM AUTHOR]

Abstract: Context: 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. Objectives: The objective of this systematic review was to search and synthesize the prevalence figures of symptoms in older palliative care patients with cancer. Methods: 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. Results: 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. Conclusion: 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. [Copyright &y& Elsevier]

Background: Evidence on the differences in symptom patterns between older palliative cancer and non-cancer patients is lacking. The purpose of the study was to determine the differences in symptoms between older hospitalised palliative cancer and non-cancer patients.Methods: A secondary analysis of two multi-centre cross-sectional studies was performed. A validated instrument was used to assess the frequency and intensity of 40 symptoms in older hospitalised palliative cancer patients (n = 100) and older palliative non-cancer patients (n = 100). The data were collected between March 2013 and June 2015. Differences between groups were measured statistically.Results: Overall, similarities in symptom patterns were observed between cancer and non-cancer patients. Some minor differences were detected between the groups. Non-cancer patients experienced significantly more physical symptoms and functional dependence than cancer patients. Patients with cancer experienced higher levels of frequency and intensity of psychological symptoms compared to non-cancer patients.Conclusions: Healthcare professionals should be aware of the high occurrence of symptoms in both cancer and non-cancer patients, and they should be educated about the systematic assessment of symptoms in multiple domains by accounting for the occurrence of generic symptoms and disease-specific symptoms. [ABSTRACT FROM AUTHOR]