Skip to main content

Advertisement

SpringerLink
Log in

Frequency of side effects in outpatient cancer care and their influence on patient satisfaction—a prospective survey using the PASQOC® questionnaire

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Study objectives

The aims of the study were to examine the frequency of side effects and fatigue in ambulatory cancer patients and to analyse how these symptoms are reflected in patient satisfaction.

Setting

Private practices (N = 41) and day hospitals (N = 8) in Germany took part in the study.

Participants

The respondents were 4,538 patients with cancer (response rate: 82%). The diagnoses were: 25% breast cancer, 21% colorectal cancer, 11% lymphomas and 12% haematological malignancies; mean age 63.5 years; 57% female.

Measurements

The 2004 PASQOC® questionnaire contained 63 problem-oriented items which covered patient satisfaction for 15 dimensions of care. One item specifically assessed the prevalence of 17 different side effects. A score reflecting the severity of fatigue (fatigue index) was computed from three additional questions. For statistical analysis of patient satisfaction, the problem frequency was computed for each item.

Results

The most frequent single side effects were fatigue (60%), hair loss (54%), nausea (51%), sleep disturbance (42%), weight loss (36%), diarrhoea (32%) and mouth ulcerations (31%). The mean number of side effects was 5 per patient (range 0 to 17). The fatigue index revealed that 42% of subjects complained of moderate and 28% of severe fatigue. Both the total number of side effects and the fatigue score were negatively associated with patient satisfaction.

Conclusions

Side effects and especially fatigue are frequent problems in cancer patients and are related to the patients’ assessment of cancer care. Routine symptom assessment may identify patients who require more comprehensive supportive care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC (1993) The European organization for research and treatment of cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376

    Article  PubMed  CAS  Google Scholar 

  2. Carr D, Goudas L, Lawrence D (2002) Management of cancer symptoms: pain, depression, and fatigue. Evidence Report/Technology Assessment No. 61 (Prepared by the New England Medical Center Evidence-based Practice Center under Contract No 290-97-0019) AHRQ Publication No. 02-E032

  3. Chang VT, Hwang SS, Feuerman M, Kasimis BS (2000) Symptom and quality of life survey of medical oncology patients at a veterans affairs medical center: a role for symptom assessment. Cancer 88:1175–1183

    Article  PubMed  CAS  Google Scholar 

  4. Cleary PD (2006) The increasing importance of patient surveys. Quality and Safety in Health Care 8:212

    Article  Google Scholar 

  5. Coulter A (2006) Can patients assess the quality of health care. BMJ 333:1–2

    Article  PubMed  Google Scholar 

  6. Dodd MJ, Miaskowski C, Lee KA (2004) Occurrence of symptom clusters. J Natl Cancer Inst Monogr 32:76–78

    Article  PubMed  Google Scholar 

  7. Epstein JB, Emerton S, Kolbinson DA, Le ND, Phillips N, Stevenson-Moore P, Osoba D (1999) Quality of life and oral function following radiotherapy for head and neck cancer. Head Neck 21:1–11

    Article  PubMed  CAS  Google Scholar 

  8. Hoekstra J, de VR, van Duijn NP, Schade E, Bindels PJ (2006) Using the symptom monitor in a randomized controlled trial: the effect on symptom prevalence and severity. J Pain Symptom Manage 31:22–30

    Article  PubMed  Google Scholar 

  9. Homsi J, Walsh D, Rivera N, Rybicki LA, Nelson KA, Legrand SB, Davis M, Naughton M, Gvozdjan D, Pham H (2006) Symptom evaluation in palliative medicine: patient report vs systematic assessment. Support Care Cancer 14:444–453

    Article  PubMed  Google Scholar 

  10. Kleeberg UR, Feyer P, Guenther W, Behrens M (2008) Patient satisfaction in outpatient cancer care: a prospective survey using the PASQOC questionnaire. Support Care Cancer; online first DOI 10.1007/s00520-007-0362-4

  11. Kleeberg UR, Tews JT, Ruprecht T, Hoing M, Kuhlmann A, Runge C (2005) Patient satisfaction and quality of life in cancer outpatients: results of the PASQOC study. Support Care Cancer 13:303–310

    Article  PubMed  CAS  Google Scholar 

  12. Miaskowski C, Dodd M, Lee K (2004) Symptom clusters: the new frontier in symptom management research. J Natl Cancer Inst Monogr 32:17–21

    Article  PubMed  Google Scholar 

  13. Moro C, Brunelli C, Miccinesi G, Fallai M, Morino P, Piazza M, Labianca R, Ripamonti C (2006) Edmonton symptom assessment scale: Italian validation in two palliative care settings. Support Care Cancer 14:30–37

    Article  PubMed  Google Scholar 

  14. National Research Corporation (2003) Development and Validation of the Picker Ambulatory Oncology Survey Instrument in Canada

  15. Paice JA (2004) Assessment of symptom clusters in people with cancer. J Natl Cancer Inst Monogr 32:98–102

    Article  PubMed  Google Scholar 

  16. Patrick DL, Ferketich SL, Frame PS, Harris JJ, Hendricks CB, Levin B, Link MP, Lustig C, McLaughlin J, Reid LD, Turrisi AT III, Unutzer J, Vernon SW (2004) National Institutes of Health State-of-the-Science Conference Statement: symptom management in cancer: pain, depression, and fatigue, July 15–17, 2002. J Natl Cancer Inst Monogr 32:9–16

    PubMed  Google Scholar 

  17. Potter J, Hami F, Bryan T, Quigley C (2003) Symptoms in 400 patients referred to palliative care services: prevalence and patterns. Palliat Med 17:310–314

    Article  PubMed  Google Scholar 

  18. Rüffer JU (2006) Fatigue—das unterschätze symptom. Im Focus Onkologie 10:3333–3336

    Google Scholar 

  19. Smets EM, Garssen B, Bonke B, de Haes JC (1995) The Multidimensional Fatigue Inventory (MFI) psychometric qualities of an instrument to assess fatigue. J Psychosom Res 39:315–325

    Article  PubMed  CAS  Google Scholar 

  20. Stone P, Richards M, A’Hern R, Hardy J (2000) A study to investigate the prevalence, severity and correlates of fatigue among patients with cancer in comparison with a control group of volunteers without cancer. Ann Oncol 11:561–567

    Article  PubMed  CAS  Google Scholar 

  21. Vainio A, Auvinen A (1996) Prevalence of symptoms among patients with advanced cancer: an international collaborative study. Symptom Prevalence Group. J Pain Symptom Manage 12:3–10

    Article  PubMed  CAS  Google Scholar 

  22. Walsh D, Donnelly S, Rybicki L (2000) The symptoms of advanced cancer: relationship to age, gender, and performance status in 1,000 patients. Support Care Cancer 8:175–179

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

The authors are indebted to the participating study sites, the dedicated staff, Prof. Mühlig for validation of the questionnaire and in particular the participating patients and their relatives.

We thank Prof. Dr. Gratiana Steinkamp, Hannover, who provided medical writing services on behalf of GlaxoSmithKline GmbH & Co. KG, Munich, Germany. This study has been sponsored by GlaxoSmithKline. PASQOC® is a trade mark of GlaxoSmithKline.

Author information

Authors and Affiliations

  1. Radioonkologie und Radiotherapie, Vivantes Klinikum Berlin Neukoelln, Berlin, Germany

    Petra Feyer & Maria Steingräber

  2. Hämatologisch-onkologische Praxis Altona (HOPA), 22765, Hamburg, Germany

    Ulrich R. Kleeberg

  3. Picker Institut Deutschland, Hamburg, Germany

    Wolfram Günther

  4. GlaxoSmithKline GmbH & Co. KG, München, Germany

    Monika Behrens

Authors
  1. Petra Feyer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ulrich R. Kleeberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Maria Steingräber
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Wolfram Günther
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Monika Behrens
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Monika Behrens.

Additional information

Presented as an invited lecture at the MASCC/ISOO 20th Anniversary International Symposium Supportive Care in Cancer in St. Gallen, June 2007.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Feyer, P., Kleeberg, U.R., Steingräber, M. et al. Frequency of side effects in outpatient cancer care and their influence on patient satisfaction—a prospective survey using the PASQOC® questionnaire. Support Care Cancer 16, 567–575 (2008). https://doi.org/10.1007/s00520-008-0422-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-008-0422-4

Keywords

Search

Navigation