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The symptom burden and the assessment of palliative symptoms in patients with metastatic upper gastrointestinal cancer: A qualitative interview study

Published online by Cambridge University Press:  11 October 2023

Maja Sønderup Tarp Open the ORCID record for Maja Sønderup Tarp [Opens in a new window]  and
Jacob Rosenberg Open the ORCID record for Jacob Rosenberg [Opens in a new window]
Maja Sønderup Tarp*
Affiliation:
Department of Surgery, Herlev & Gentofte Hospital, University of Copenhagen, Herlev, Denmark
Jacob Rosenberg
Affiliation:
Department of Surgery, Herlev & Gentofte Hospital, University of Copenhagen, Herlev, Denmark
*
Corresponding author: Maja Sønderup Tarp; Email: maja.soenderup.tarp@regionh.dk
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Abstract

Objectives

Patients with metastatic upper gastrointestinal (GI) cancer may experience a large physical symptom burden. However, less is known about existential, social, and psychological symptoms. To provide the patient with palliative care, quality-of-life questionnaires are used for structured needs assessment. These are sporadically implemented, and there seems to be uncertainty to the efficiency of current practice. The aim of study was to explore the experienced assessment-process and treatment of palliative symptoms, as well as the experienced symptom burden, in patients with metastatic upper GI cancer.

Methods

Qualitative, semi-structured interviews were conducted in 10 patients with metastatic upper GI cancer. Data were analyzed using content analysis.

Results

The patients did not expect treatment for all physical symptoms. Existential symptoms revolved around death and dying, social issues were mainly related to family, and psychological issues were based in the continuous dealing with serious illness. Existential, social, and psychological symptoms were mostly not considered part of the expected care when admitted to hospital. Patients had only vague recollections of their experiences with structured needs assessment, and the process had been inconsequential in the treatment of symptoms.

Significance of results

Patients with upper GI cancer experience symptoms related to all 4 areas of palliative care being physical, existential, social, and psychological, but these are differentiated in the way patients perceive their origins and treatability. Structured needs assessment was not routinely carried out, and in cases where this had been done, no follow-up was effectuated. This calls for increased focus and proper implementation for the process to be relevant in the treatment of palliative symptoms.

Keywords

Palliative careSymptom burdenUpper gastrointestinal cancerNeeds assessment
Type
Original Article
Information
Palliative & Supportive Care , Volume 22 , Issue 2 , April 2024 , pp. 367 - 373
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Copyright
© The Author(s), 2023. Published by Cambridge University Press.

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