Congress Abstracts 2003

21

TOTAL SYMPTOM SCORES IMPACT HOSPICE PATIENTS’ FUNCTIONAL STATUS AND QUALITY OF LIFE. Barbara Raudonis, PhD, RN, CS, University of Texas at Arlington, Arlington, TX.

Symptom management is a principle of palliative care. Uncontrolled symptoms, individually or in clusters, affect the functional status and quality of life of hospice patients. Our lack of knowledge about symptom clusters impedes effective symptom relief. Thus, further research is needed on the impact of symptom clusters. The purpose of this study was to identify individual symptoms and symptom combinations or clusters experienced at end of life and evaluate their relationship with functional performance and quality of life. The UCSF School of Nursing Symptom Management Faculty Group’s Model for Symptom Management served as the conceptual framework for this study. The model’s broad perspective of symptom management includes three dimensions: Symptom experience, symptom management strategies, and symptom outcomes. This descriptive, correlational study focused on symptom outcomes. Participants were English-speaking adult hospice patients not actively dying and not delirious. The Mini-Mental Exam screened for cognitive impairment. Data collection instruments included the Edmonton Symptom Assessment System, Palliative Performance Scale (function), and Missoula-VITAS Quality-of-Life Index. A convenience sample of 50 hospice patients included 26 females and 24 males. Their ages ranged from 40 to 96 years; mean age was 73 years. Sample was 82% Caucasian, 10% Black, and 8% Hispanic. Sixty-eight percent had a cancer diagnosis. Most common cancers were lung (18%), colon (8%), and prostate (8%). Thirty-two percent had non-cancer diagnoses. Most prevalent non-cancer diagnoses were CHF and COPD. Data were analyzed using descriptive statistics (means, standard deviations, percentages, and frequencies) and Pearson correlation coefficients. Results suggest that symptom combinations may have a synergistic effect on quality of life and functional status. There were significant negative correlations between depression, general well-being, and quality of life. However, none of the univariate symptoms remained significant in the multiple regression analysis. The correlations between the total symptom score, quality of life, and functional status remained significant in the negative direction. Findings support the need for more research in order to understand the effects of symptom clusters (3 symptoms) or multiple symptoms (more than 3) on quality of life and functional status.

Funding Source: ONS Foundation/Roxanne Laboratories Research Grant.