台灣老年癌末病患的症狀

Symptoms in the Elderly with Terminal Cancer: a Study in Taiwan

10.6320/FJM.2002.6(4).01

許秀卿(Hsiu-Chin Hsu)；胡文郁(Wen-Yu Hu)；莊榮彬(Rong-Bin Chuang)；邱泰源(Tai-Yuan Chiu)；陳慶餘(Ching-Yu Chen)

老年 ； 癌症末期 ； 症狀 ； 盛行率 ； elderly ； terminal cancer ； symptoms ； prevalence

台灣醫學

6卷4期（2002 / 07 / 01）

465 - 473

繁體中文

The suffering of elderly with terminal cancer is gaining increasing attention in the field of health care delivery system. In order to investigate the symptoms which are distressing the elder patients with terminal cancer. This study was conducted to examine the prevalence and severity of symptoms in elder patients with terminal cancer. In addition, to compare the changes of severity after admission. Two hundred and twenty eight terminal cancer patients more than 65 years old, admitted to palliative care unit in National Taiwan University Hospital from September 1997 to April 1999, were enrolled. A structured data collection form was used daily to evaluate symptoms, which were analyzed at the time of admission, 1 week after admission and 48h before death. There were equal number in both gender. Mean age of all patients was 73.9±6.3 years; their mean survival time was 21.3±34.8 days. More than eighty percent (82.5%) of patients, whose ECOG performance was grade 3 or 4. Patients averaged 9.9 symptoms each at the time of admission. The prevalence of some of the symptoms was: weakness (88.5%), anorexia (88.1%), pain (77.9%), weight loss (72.0%); these were predominant symptoms of cancer in most primary sites. After one week in hospice pain was improved (p＜0.05); the mean scores of dyspnea, nausea, vomiting, insomnia, dry mouth decreased but didn’t have statistical significance (p＞0.05). However, all symptoms except pain tended to worse in the 48h before death. In conclusion, elder patients with terminal cancer were polysymptomatic. The high prevalence of symptoms distressed the elder patients and reduced their quality of life. Management of these symptoms are usually complicated due to the characteristics of elderly such as deteriorating organ function and poor physical performance. Symptom control and care of dying in elderly with terminal cancer will be a challenge in the field of geriatric and palliative medicine.

The suffering of elderly with terminal cancer is gaining increasing attention in the field of health care delivery system. In order to investigate the symptoms which are distressing the elder patients with terminal cancer. This study was conducted to examine the prevalence and severity of symptoms in elder patients with terminal cancer. In addition, to compare the changes of severity after admission. Two hundred and twenty eight terminal cancer patients more than 65 years old, admitted to palliative care unit in National Taiwan University Hospital from September 1997 to April 1999, were enrolled. A structured data collection form was used daily to evaluate symptoms, which were analyzed at the time of admission, 1 week after admission and 48h before death. There were equal number in both gender. Mean age of all patients was 73.9±6.3 years; their mean survival time was 21.3±34.8 days. More than eighty percent (82.5%) of patients, whose ECOG performance was grade 3 or 4. Patients averaged 9.9 symptoms each at the time of admission. The prevalence of some of the symptoms was: weakness (88.5%), anorexia (88.1%), pain (77.9%), weight loss (72.0%); these were predominant symptoms of cancer in most primary sites. After one week in hospice pain was improved (p＜0.05); the mean scores of dyspnea, nausea, vomiting, insomnia, dry mouth decreased but didn’t have statistical significance (p＞0.05). However, all symptoms except pain tended to worse in the 48h before death. In conclusion, elder patients with terminal cancer were polysymptomatic. The high prevalence of symptoms distressed the elder patients and reduced their quality of life. Management of these symptoms are usually complicated due to the characteristics of elderly such as deteriorating organ function and poor physical performance. Symptom control and care of dying in elderly with terminal cancer will be a challenge in the field of geriatric and palliative medicine.