Authors (including presenting author) :
Ma CM(1), Chan LM(1), Ip HY(1), Chow TF(1), Chan TY(1), Chiu PC(1), Ng HY(2), Ko PS(2), Hung KW(3), Pun YM(1)
Affiliation :
1.Palliative Care Service, Department of Medicine, Haven of Hope Hospital.
2.Nursing Services Division, United Christian Hospital.
3.Medical Social Work Department, Haven of Hope Hospital.
Introduction :
Priority symptoms (PS) are the symptoms that the patients find most distressing/concerning but they may not be the most severe symptoms (Annette et al., 2006; Linder et al.,2019). If priority symptoms, instead of all noticed symptoms, can be highlighted and managed properly in non-PC wards after PC inpatient consultations, it allows focused parent team assessment and management. In long run, the culture of addressing patients’ needs and concerns as priority could be demonstrated and cultivated in non-palliative care settings. Indeed, this is one of the most important goals of having PC inpatient consultation in non-palliative care settings other than just prompt symptom control and psycho-spiritual care.
Objectives :
To report which three priority symptoms that patients complaint most and theirs changes after first PC inpatient consultations in Tseung Kwan O and Haven of Hope Hospital non-PC wards.
Methodology :
A hand-on electronic record method was first designed and used since 1st April 2021 for prospective records of patients’ first three priority symptoms in first and second PC inpatient consultations. Edmonton Symptom Assessment System (ESAS), a screening tool for systematic assessment for severity of common PC symptoms, was applied.
Result & Outcome :
There were altogether 807 patients having PC inpatient consultations from 1st April 2021 to 30th September 2022. The average duration between first and second PC inpatient consultations was 2.6 days The average age of those patients with the three commonest priority symptoms (n = 545) was 71. 53% were male patients and 92 % and 8 % were cancer and non-cancer patients respectively. . The three commonest priority symptoms were pain (55% ), shortness of breath (SOB) (34%) and nausea/vomiting(N/V) (11%).
Among patients with record of second assessment, overall improvement in priority symptoms:
For pain (n=76), improved in 53%, static in 36% and worsened in 11%.
For SOB (n=49), improved in 53%, static in 33% and worsened in 14%.
For N/V (n=45), improved in 67%, static in 26% and worsened in 7%.
The reasons for not having subsequent records for severities of priority symptoms were patients unable to express their subsequent symptom severity(80%)and missing data (20%).
Conclusion
Priority symptom assessment and management can help to cultivate the culture of addressing patients’ needs and concerns. More than half of the PC patients could have their priority symptoms improved in second review records after first PC inpatient consultations in non—PC wards.
