Pain Intensity, Quality of Life, Quality of Palliative Care, and Satisfaction in Outpatients With Metastatic or Recurrent Cancer: A Japanese, Nationwide, Region-Based, Multicenter Survey

Context. Increasing numbers of patients with advanced cancer are receiving anticancer and/or palliative treatment in outpatient settings, and palliative care for outpatients with advanced cancer is being recognized as one of the most important areas for comprehensive cancer treatment. Objectives. The aim of this study was to evaluate pain intensity, quality of life, quality of palliative care, and satisfaction reported by outpatients with advanced cancer. Methods. Questionnaires were sent to 1493 consecutive outpatients with metastatic or recurrent cancer from four regions in Japan; 859 responses were analyzed (58%). Questionnaires included the Brief Pain Inventory, Good Death Inventory, Care Evaluation Scale, and a six-point satisfaction scale. Results. Approximately 20% of the patients reported moderate to severe pain. Whereas more than 70% agreed or strongly agreed with good relationship with medical staff and being respected as an individual, less than 60% agreed or strongly agreed with free from physical distress, free from emotional distress, maintaining hope, and fulfillment at life's completion; 54% reported some agreement with feel a burden to others. About 20% reported that improvement is necessary in physical care by physicians, physical care by nurses, psycho-existential care, help with decision making, and coordination/consistency of care; 13% reported some levels of dissatisfaction. Conclusion. A considerable number of outpatients with metastatic or recurrent cancer experienced pain, physical symptoms, emotional distress, and existential suffering, and advocated improvements in palliative care across multiple areas. J Pain Symptom Manage 2012;43:503-514. (C) 2012 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.