Distrés en adultos con enfermedad oncológica terminal y con enfermedades sistémicas avanzadas no terminales: un estudio prospectivo observacional

Abstract

Introduction. Distress impacts the quality of life and death of patients with advanced oncologic disease. Objective. To compare the frequency of perceived distress of adults with advanced and systemic oncologic disease, as well as to identify the main affective correlates by means of simple relative frequencies in percentages. Material and Methods. In this descriptive study we evaluated adults with stage IV oncologic disease, who knew their terminal status, who were managed in a palliative care (PC) clinic; and patients with non-terminal advanced disease not attending a PC clinic. The Palliative Performance Scale: PPS, Edmonton Symptom Assessment Scale and The Distress Thermometer) were applied to evaluate the frequency and severity of distress. Results. Both groups had a mean of 25.4 ± 35.5 months with the disease. PPS score was lower in patients receiving PC (49.3 ± 19.0) comparing with the non-terminal ones (61.2 ± 17.1) (p < 0.05). The prevalence of distress was 71.4 % (75 % in PC patients, and 70 % in the second group). The main problems perceived by both groups were physical (pain, 41 %) and emotional (sadness, 22 %). Patients not receiving PC perceived more practical problems (economical), as compared with the terminal patients (17.2 % vs. 8.8 %, respectively; p < 0.05). Compared with men, women reported less tranquility, more sorrow and fear (p < 0.05). Conclusions. The prevalence of distress in our patients with advanced disease is among the highest reported in literature. The distinguishing characteristics of patients with terminal disease are different from those with a less advanced process.