"Now that you mention it, doctor ... ": symptom reporting and the need for systematic questioning in a specialist palliative care unit.

Abstract

To determine which symptoms experienced by patients admitted to a specialist palliative care unit are self-reported (SR) and which are only detected with systematic questioning (SQ). A retrospective chart review was performed of 50 patients. The admission proforma was reviewed to determine symptoms present, which were SR, and which were only detected upon SQ. An average of 13 symptoms were experienced (SR + SQ) per patient (range, 5-24). Forty-two different symptoms were SR, with an average of 4 per patient (range, 1-10). The most common SR symptoms were pain (72%), bowel disturbance (32%), nausea or vomiting (30%), mobility problems (30%), and loss of appetite (24%). On SQ of 38 common symptoms, there was an average of 8 further symptoms per patient detected (range, 1-18). The most common symptoms detected on SQ were weight loss (66%), fatigue (56%), loss of appetite (48%), mobility problems (42%), edema/ lymphedema (36%), oral symptoms (36%), confusion/memory loss (36%), sleep problems (36%), bowel disturbance (34%), drowsiness (32%), and low mood (28%). Patients have many symptoms that are not SR on admission. SQ plays a vital role in the detection of symptoms that may require further assessment or treatment.