Self assessment of health status and symptoms by cancer patients

Abstract

Abstract A study was carried out to assess the value and feasibility of using a short questionnaire to evaluate overall health status and common symptoms in cancer patients attending an outpatient clinic. A cancer specific questionnaire (CSQ) was developed to assess the impact of cancer on overall health, appetite, energy, mood and pain. Patient ratings were compared with the doctor rating made at the same time. A pilot study was carried out in 20 patients to identify any practical problems associated with administration of the CSQ. Thirty patients deemed to be clinically stable were asked to complete the CSQ on two separate occasions to assess its reliability. Three hundred patients were recruited to the main study. In the pilot study, the CSQ was found to be comprehensible and practical to use. Subjects required between two and five minutes to complete the CSQ. No statistically significant difference in any of the categories of the CSQ (chi-squared test, P>0.05) was found in the 30 patients who completed the CSQ on two occasions. In the main study, the majority (72 per cent) of patients considered their overall health status as fair to good. Appetite was rated as normal in 63 per cent of patients. Only 22 per cent of patients considered their energy status as normal. Fifty-two per cent of the patients rated their mood as normal. Fifty-seven per cent of patients had some degree of pain. There was no statistically significant difference (ehi-squared, P>0.05) between doctor and patient ratings made on the same occasion in any category. Assessments matched closely in cases where there was no impairment in the category assessed. However, when there was some impairment doctor and patient agreement fell to less than 50 per cent. The data obtained were useful in the identification of problems but did not provide sophisticated qualitative information regarding the nature of the symptoms. The information obtained from the patient could provide a focus for further discussion during the medical consultation.