Symptom recognition in advanced cancer. A comparison of nursing records against patient self-rating

The aim of the study was to investigate the extent to which the symptoms ex perienced by advanced cancer patients were covered by the nursing records. On the day of the first contact with our palliative care department, a nurs ing record was taken, and on this or the following day, 56 patients filled in the questionnaires EORTC Quality of Life Questionnaire (EORTC QLQ-C30), Edmonton Symptom Assessment System (ESAS), and Hospital Anxiety and Depress ion Scale (HADS). In each patient, the symptomatology reported in the patie nt-completed questionnaires was compared with the symptomatology mentioned by the nurse in the nursing record. The analysis revealed good concordance concerning pain and poor physical functioning, but patients reported other symptoms or problems much more often than their nurses. Reasons for these d iscrepancies are discussed. It is suggested that the nurse's knowledge of t he patient's symptomatology might gain from more systematic screening or fr om transfer of information from patient self-assessment questionnaires to t he nursing records.