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Tuesday, November 3, 2009: 1:55 PM
Learning Objective 1: understand patient reports of pain severity and impact on QOL at admission to hospice and 10-14 days after.
Learning Objective 2: understand how pain correlates to other QOL symptoms in cancer patients.
Background Gathering information about patients in the final stages of terminal cancer is difficult for many reasons including frailty, cognitive impairment, gatekeeping by hospice providers and caregivers, excessive fatigue, and critical illness. The purpose of this paper is to share the experience of pain and quality of life of older hospice patients as reported by the patient or their caregiver’s during their first two weeks of hospice care obtained as part of an ongoing research project. Methods Data for this paper was collected from telephone interviews with 94 older adults with cancer or their caregivers receiving hospice service in a home setting through 16 Midwestern hospices. Participants completed one to two telephone interviews during the first two weeks of their hospice experience. Instruments used to gather objective information include the Brief Pain Inventory (BPI) and the Brief Hospice Inventory (BHI). Results: One-sample paired T-tests and Pearson product-moment correlations were used. Overall pain interference with general activity showed an average reporting of 3.06(3.76) for the first interview and 3.02(3.87) for the second interview. Overall QOL as reported by the patient decreased from 4.36(3.19) to 6.07(2.81) from the first to the second interview. Mean overall QOL as reported by the caregiver also decreased from 4.39(2.78) to 6.26 (3.08) for the first and second interview respectively. Pain interference improved between interview 1 and 2 for all indicators except walking ability and relationships with other people. Examining the relationship between pain and QOL symptoms and other factors resulted in several significant correlations. Discussion Older patients with cancer newly admitted to hospice experience pain and other symptoms that interfere with activity and overall QOL. Reports from patients compared to those from caregivers suggest that patients unable to self-report may be experiencing worsening symptoms and progression in the final stages of life.