Introduction: Cancer patients in palliative care frequently experience psychological distress, encompassing cognitive, behavioral, and emotional dimensions. This distress can significantly affect their capacity to accept the inevitability of death. Commonly, such distress manifests as sadness, depression, anxiety, and fear, which may culminate in an existential crisis. Objectives: The purpose of this study was to analyze the psychometric properties of the Edmonton Symptom Assessment System (ESAS) and the Palliative Outcome Scale (POS) among hospitalized cancer patients receiving palliative care in a Portuguese palliative care unit. Methods: Data were collected from psychological screening instruments (ESAS and POS) used in oncology patients admitted to an oncology palliative service. The study period spanned from January 2021 to March 2021. Results: The study included a convenience sample of 60 patients diagnosed with advanced cancer who were sequentially admitted to a palliative care unit. The most frequently reported primary oncological diagnoses were gastrointestinal (41.7%) and head/neck (20%) tumors. The majority of the patients were male (n= 37; 61.7%), with a median age of 72 years (range: 43–94 years). Key findings from the analysis indicated the following associations: anxiety and self-reported symptoms (higher levels of patient anxiety related to illness or treatment were strongly correlated with increased self-reported anxiety (p< 0.01)); emotional sharing and perceived meaning of life (patients who shared their feelings less frequently with family and friends were significantly less likely to find meaning in life (p< 0.01) and were more likely to report a poorer self-perception (p< 0.05)); understanding the importance of life and self-perception (a diminished understanding of the importance of life was associated with worsened self-perception (p< 0.01)); anxiety and depressive symptoms (greater anxiety related to the disease or its treatment correlated with an increased severity of depressive symptoms (p< 0.01)). Discussion and conclusion: There are numerous validated instruments available for measuring emotional distress. Among these, the ESAS and POS complement each other as practical and easy-to-use tools for evaluating emotional distress in patients admitted to palliative care settings. Findings revealed that anxiety and concerns related to the disease and its treatment, as measured by the POS, served as predictors of the risk for self-reported anxiety and depression identified by the ESAS. Furthermore, the items within the POS that evaluate the emotional component demonstrated strong internal correlation, supporting their combined use for a comprehensive assessment of this dimension.
引言：接受姑息治疗的癌症患者常经历心理困扰，涵盖认知、行为及情感多个维度。这种困扰可能显著影响患者接受死亡必然性的能力。此类困扰通常表现为悲伤、抑郁、焦虑和恐惧，并可能最终引发存在危机。目的：本研究旨在分析葡萄牙某姑息治疗病房住院癌症患者中埃德蒙顿症状评估系统（ESAS）与姑息治疗结局量表（POS）的心理测量学特性。方法：数据来源于肿瘤姑息治疗服务收治患者使用的心理筛查工具（ESAS与POS）。研究周期为2021年1月至2021年3月。结果：研究纳入60例经连续收治至姑息治疗病房的晚期癌症患者作为便利样本。最常见的原发肿瘤诊断为胃肠道肿瘤（41.7%）和头颈部肿瘤（20%）。患者以男性为主（n=37；61.7%），中位年龄72岁（范围：43-94岁）。分析显示以下关键关联：焦虑与自我报告症状（患者对疾病或治疗的焦虑程度与自我报告的焦虑增强显著相关（p<0.01））；情感分享与生命意义感知（较少与亲友分享感受的患者明显更难以发现生命意义（p<0.01），且更可能报告较差的自我认知（p<0.05））；生命重要性认知与自我感知（对生命重要性的理解减弱与自我认知恶化相关（p<0.01））；焦虑与抑郁症状（对疾病或治疗的焦虑程度增加与抑郁症状加重相关（p<0.01））。讨论与结论：目前已有多种经过验证的情绪困扰评估工具。其中ESAS与POS作为实用且易操作的评估工具，在姑息治疗住院患者的情绪困扰评估中具有互补性。研究发现，通过POS评估的疾病及相关治疗引发的焦虑与担忧，可作为ESAS识别的自我报告焦虑和抑郁风险的预测指标。此外，POS量表中评估情感维度的条目显示出良好的内部相关性，支持将其联合使用以实现对该维度的全面评估。
肿瘤(癌症)患者之家