Edmonton Scale Symptoms and Comfort in Adult Cancer Patients Receiving Palliative Care: A Cross-Sectional Study
DOI:
https://doi.org/10.12707/RVI26.6.45206Keywords:
palliative care, neoplasms, oncology nursing, symptoms, patient comfort, quality of lifeAbstract
Background: Cancer patients receiving palliative care experience physical and psychological symptoms that compromise comfort.
Objective: To analyze the intensity of symptoms assessed by the Edmonton Symptom Assessment System and their relationship with general comfort in hospitalized cancer patients receiving palliative care.
Methodology: Cross-sectional, quantitative and analytical study conducted with 155 patients admitted to a federal oncology referral hospital in Rio de Janeiro, Brazil, between July 2024 and January 2025. The Edmonton Symptom Assessment System and the General Comfort Questionnaire were applied.
Data were analyzed using descriptive statistics and Spearman’s correlation.
Results: Significant inverse correlations were observed between symptom intensity and general comfort, especially for total symptom score (r = -0.614; p < 0.001), reduced well-being (r = -0.535; p < 0.001), depression (r = -0.504; p < 0.001), anxiety (r = -0.448; p < 0.001), fatigue (r = -0.409; p < 0.001), and pain (r = -0.374; p < 0.001). Dyspnea showed no significant correlation (p = 0.193).
Conclusion: Greater symptom intensity was associated with lower comfort, reinforcing the importance of systematic assessment and integrated nursing interventions.
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References
Henson, L. A., Maddocks, M., Evans, C. J., Davidson, M., Hicks, S., & Higginson, I. J. (2020). Palliative care and the management of common distressing symptoms in advanced cancer: Pain, breathlessness, nausea and vomiting, and fatigue. Journal of Clinical Oncology, 38(9), 905–914. https://doi.org/10.1200/JCO.19.00470
Instituto Nacional de Câncer. (2022). A avaliação do paciente em cuidados paliativos. INCA. https://www.inca.gov.br/sites/ufu.sti.inca.local/files/media/document/completo_serie_cuidados_paliativos_volume_1.pdf
National Academy of Palliative Care. (2023). Atlas of palliative care in Brazil. https://paliativo.org.br/publicacoes-ancp
Paiva, B. S. R., Carvalho, A. L., Kolcaba, K., & Paiva, C. E. (2015). Validation of the Holistic Comfort Questionnaire-caregiver in Portuguese-Brazil in a cohort of informal caregivers of palliative care cancer patients. Supportive Care in Cancer, 23(2), 343–351. https://doi.org/10.1007/s00520-014-2370-5
Paiva, C. E., Manfredini, L. L., Paiva, B. S., Hui, D., Bruera, E., & Hui, D. (2015). The Brazilian version of the Edmonton Symptom Assessment System (ESAS) is a feasible, valid and reliable instrument for the measurement of symptoms in advanced cancer patients. PLoS One, 10(7), e0132073. https://doi.org/10.1371/journal.pone.0132073
Pereira, C. S., Paiva, R. F., Silva, R. S., Silva, A. L., & Moreira, M. C. (2020). Analysis of the comfort concept: Contributions to the nursing diagnosis of readiness for enhanced comfort. Escola Anna Nery, 24, e20190205. https://doi.org/10.1590/2177-9465-EAN-2019-0205
Sanders, J. J., Temin, S., Ghoshal, A., Sullivan, A. M., Parikh, R. B., Smith, T. J., & Prigerson, H. G. (2024). Palliative care for patients with cancer: ASCO guideline update. Journal of Clinical Oncology, 42(19), 2336–2357. https://doi.org/10.1200/JCO.24.00542
Souza, M. C., Jaramillo, R. G., & Borges, M. S. (2021). Comfort of patients in palliative care: An integrative review. Enfermería Global, 20(61), 433–448. https://doi.org/10.6018/eglobal.420751
Watson, L., Link, C., Qi, S., DeIure, A., Chmielewski, L., & Hildebrand, A. (2024). Designing and validating a comprehensive patient-reported outcomes measure for ambulatory cancer settings: The revised Edmonton Symptom Assessment System for Cancer. JCO Oncology Practice, 20(12), 1764–1775. https://doi.org/10.1200/OP.24.00088
World Health Organization. (2020). Palliative care: Key facts. https://www.who.int/news-room/fact-sheets/detail/palliative-care
