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.

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.Copyright © 2012 by Elsevier Inc. [ABSTRACT FROM AUTHOR]