The detection and treatment of cancer-related functional problems in an outpatient setting
Goals of work Cancer causes functional problems that are often neither detected nor treated in the outpatient setting. Patient–physician communication regarding functional issues may contribute. This study was conducted to quantify the degree of concordance between patient-identified functional prob...
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| Veröffentlicht in: | Supportive care in cancer 2009-01, Vol.17 (1), p.61-67 |
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| container_title | Supportive care in cancer |
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| creator | Cheville, A. L. Beck, L. A. Petersen, T. L. Marks, R. S. Gamble, G. L. |
| description | Goals of work
Cancer causes functional problems that are often neither detected nor treated in the outpatient setting. Patient–physician communication regarding functional issues may contribute. This study was conducted to quantify the degree of concordance between patient-identified functional problems and their documentation in the oncology-generated medical record.
Materials and methods
We administered a 27-item questionnaire addressing cancer-related symptoms, signs, and functional problems to a consecutive sample of 244 patients undergoing outpatient cancer treatment. Oncology clinician-generated notation in the electronic medical record (EMR) was systematically reviewed for documentation of the instrument items. EMR review began the day of instrument completion and extended retrospectively for 6 months.
Main results
Eighty-three percent (202) completed the survey with at least one cancer-related symptom, sign, or functional problem identified by 71.8%, 33.2% and 65.8% of patients, respectively. Difficulty with ambulation (23.9%) and balance (19.4%) were the most frequent functional problems. Clinician notes referred to 49% of patients’ symptoms, but only 37% of their signs and 6% of their functional problems. Pain, weight loss, and nausea (ORs > 4.9,
p
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| doi_str_mv | 10.1007/s00520-008-0461-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_66734523</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>66734523</sourcerecordid><originalsourceid>FETCH-LOGICAL-c436t-ee0012bcb25f76ef6b0d4318f3f9fc9d82bc3037106d9aa9046b4ff91e7de9a63</originalsourceid><addsrcrecordid>eNp1kE1LxDAQhoMouq7-AC8SELxFJ03aNEcRv0DwohcvIW0nWunHmqSg_97UXVAETznM876ZeQg54nDGAdR5AMgzYAAlA1lw9rFFFlwKwZQQepssQEvOpMjzPbIfwhsAVyrPdskeL6UqM5UvyPPjK9IGI9axHQdqh4ZGjzb2OEQ6OlrboUbPPHY2YkPdNHyDtqMrP1Yd9oG2c4yOU1zZ2M6xgDG2w8sB2XG2C3i4eZfk6frq8fKW3T_c3F1e3LNaiiIyxLRXVtVVljtVoCsqaKTgpRNOu1o3ZZoJEIpD0Whrdbq0ks5pjqpBbQuxJKfr3rTR-4Qhmr4NNXadHXCcgikKJWSeiQSe_AHfxsmnW4LhIDTXCvK5jq-p2o8heHRm5dve-s8EmVm7WWs3SbuZtZuPlDneNE9Vj81PYuM5AdkaCGk0vKD__fV_rV_KAI6j</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1039197056</pqid></control><display><type>article</type><title>The detection and treatment of cancer-related functional problems in an outpatient setting</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Cheville, A. L. ; Beck, L. A. ; Petersen, T. L. ; Marks, R. S. ; Gamble, G. L.</creator><creatorcontrib>Cheville, A. L. ; Beck, L. A. ; Petersen, T. L. ; Marks, R. S. ; Gamble, G. L.</creatorcontrib><description>Goals of work
Cancer causes functional problems that are often neither detected nor treated in the outpatient setting. Patient–physician communication regarding functional issues may contribute. This study was conducted to quantify the degree of concordance between patient-identified functional problems and their documentation in the oncology-generated medical record.
Materials and methods
We administered a 27-item questionnaire addressing cancer-related symptoms, signs, and functional problems to a consecutive sample of 244 patients undergoing outpatient cancer treatment. Oncology clinician-generated notation in the electronic medical record (EMR) was systematically reviewed for documentation of the instrument items. EMR review began the day of instrument completion and extended retrospectively for 6 months.
Main results
Eighty-three percent (202) completed the survey with at least one cancer-related symptom, sign, or functional problem identified by 71.8%, 33.2% and 65.8% of patients, respectively. Difficulty with ambulation (23.9%) and balance (19.4%) were the most frequent functional problems. Clinician notes referred to 49% of patients’ symptoms, but only 37% of their signs and 6% of their functional problems. Pain, weight loss, and nausea (ORs > 4.9,
p
< 0.004) were most likely to be documented while functional problems (OR 0.2,
p
< 0.0001) were the least likely to be noted. Two rehabilitation physician referrals were generated for pain and limb swelling, but no functional problems were formally addressed.
Conclusion
Functional problems are prevalent among outpatients with cancer and are rarely documented by oncology clinicians. A more aggressive search for, and treatment of, these problems may be beneficial for outpatients with cancer.</description><identifier>ISSN: 0941-4355</identifier><identifier>EISSN: 1433-7339</identifier><identifier>DOI: 10.1007/s00520-008-0461-x</identifier><identifier>PMID: 18478275</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Activities of daily living ; Adult ; Aged ; Aged, 80 and over ; Ambulatory Care - standards ; Cancer ; Documentation ; Female ; Humans ; Male ; Medical records ; Medical Records Systems, Computerized - standards ; Medicine ; Medicine & Public Health ; Middle Aged ; Minnesota ; Nausea ; Neoplasms - complications ; Neoplasms - physiopathology ; Neoplasms - rehabilitation ; Nursing ; Nursing Research ; Oncology ; Original Article ; Pain Medicine ; Patients ; Practice Patterns, Physicians' - standards ; Questionnaires ; Referral and Consultation ; Rehabilitation ; Rehabilitation Medicine ; Retrospective Studies ; Surveys and Questionnaires ; Young Adult</subject><ispartof>Supportive care in cancer, 2009-01, Vol.17 (1), p.61-67</ispartof><rights>Springer-Verlag 2008</rights><rights>Springer-Verlag 2009</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c436t-ee0012bcb25f76ef6b0d4318f3f9fc9d82bc3037106d9aa9046b4ff91e7de9a63</citedby><cites>FETCH-LOGICAL-c436t-ee0012bcb25f76ef6b0d4318f3f9fc9d82bc3037106d9aa9046b4ff91e7de9a63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00520-008-0461-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00520-008-0461-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27929,27930,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18478275$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cheville, A. L.</creatorcontrib><creatorcontrib>Beck, L. A.</creatorcontrib><creatorcontrib>Petersen, T. L.</creatorcontrib><creatorcontrib>Marks, R. S.</creatorcontrib><creatorcontrib>Gamble, G. L.</creatorcontrib><title>The detection and treatment of cancer-related functional problems in an outpatient setting</title><title>Supportive care in cancer</title><addtitle>Support Care Cancer</addtitle><addtitle>Support Care Cancer</addtitle><description>Goals of work
Cancer causes functional problems that are often neither detected nor treated in the outpatient setting. Patient–physician communication regarding functional issues may contribute. This study was conducted to quantify the degree of concordance between patient-identified functional problems and their documentation in the oncology-generated medical record.
Materials and methods
We administered a 27-item questionnaire addressing cancer-related symptoms, signs, and functional problems to a consecutive sample of 244 patients undergoing outpatient cancer treatment. Oncology clinician-generated notation in the electronic medical record (EMR) was systematically reviewed for documentation of the instrument items. EMR review began the day of instrument completion and extended retrospectively for 6 months.
Main results
Eighty-three percent (202) completed the survey with at least one cancer-related symptom, sign, or functional problem identified by 71.8%, 33.2% and 65.8% of patients, respectively. Difficulty with ambulation (23.9%) and balance (19.4%) were the most frequent functional problems. Clinician notes referred to 49% of patients’ symptoms, but only 37% of their signs and 6% of their functional problems. Pain, weight loss, and nausea (ORs > 4.9,
p
< 0.004) were most likely to be documented while functional problems (OR 0.2,
p
< 0.0001) were the least likely to be noted. Two rehabilitation physician referrals were generated for pain and limb swelling, but no functional problems were formally addressed.
Conclusion
Functional problems are prevalent among outpatients with cancer and are rarely documented by oncology clinicians. A more aggressive search for, and treatment of, these problems may be beneficial for outpatients with cancer.</description><subject>Activities of daily living</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Ambulatory Care - standards</subject><subject>Cancer</subject><subject>Documentation</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical records</subject><subject>Medical Records Systems, Computerized - standards</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Minnesota</subject><subject>Nausea</subject><subject>Neoplasms - complications</subject><subject>Neoplasms - physiopathology</subject><subject>Neoplasms - rehabilitation</subject><subject>Nursing</subject><subject>Nursing Research</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Pain Medicine</subject><subject>Patients</subject><subject>Practice Patterns, Physicians' - standards</subject><subject>Questionnaires</subject><subject>Referral and Consultation</subject><subject>Rehabilitation</subject><subject>Rehabilitation Medicine</subject><subject>Retrospective Studies</subject><subject>Surveys and Questionnaires</subject><subject>Young Adult</subject><issn>0941-4355</issn><issn>1433-7339</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp1kE1LxDAQhoMouq7-AC8SELxFJ03aNEcRv0DwohcvIW0nWunHmqSg_97UXVAETznM876ZeQg54nDGAdR5AMgzYAAlA1lw9rFFFlwKwZQQepssQEvOpMjzPbIfwhsAVyrPdskeL6UqM5UvyPPjK9IGI9axHQdqh4ZGjzb2OEQ6OlrboUbPPHY2YkPdNHyDtqMrP1Yd9oG2c4yOU1zZ2M6xgDG2w8sB2XG2C3i4eZfk6frq8fKW3T_c3F1e3LNaiiIyxLRXVtVVljtVoCsqaKTgpRNOu1o3ZZoJEIpD0Whrdbq0ks5pjqpBbQuxJKfr3rTR-4Qhmr4NNXadHXCcgikKJWSeiQSe_AHfxsmnW4LhIDTXCvK5jq-p2o8heHRm5dve-s8EmVm7WWs3SbuZtZuPlDneNE9Vj81PYuM5AdkaCGk0vKD__fV_rV_KAI6j</recordid><startdate>20090101</startdate><enddate>20090101</enddate><creator>Cheville, A. L.</creator><creator>Beck, L. A.</creator><creator>Petersen, T. L.</creator><creator>Marks, R. S.</creator><creator>Gamble, G. L.</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88J</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HEHIP</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2R</scope><scope>M2S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20090101</creationdate><title>The detection and treatment of cancer-related functional problems in an outpatient setting</title><author>Cheville, A. L. ; Beck, L. A. ; Petersen, T. L. ; Marks, R. S. ; Gamble, G. L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c436t-ee0012bcb25f76ef6b0d4318f3f9fc9d82bc3037106d9aa9046b4ff91e7de9a63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Activities of daily living</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Ambulatory Care - standards</topic><topic>Cancer</topic><topic>Documentation</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical records</topic><topic>Medical Records Systems, Computerized - standards</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Minnesota</topic><topic>Nausea</topic><topic>Neoplasms - complications</topic><topic>Neoplasms - physiopathology</topic><topic>Neoplasms - rehabilitation</topic><topic>Nursing</topic><topic>Nursing Research</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Pain Medicine</topic><topic>Patients</topic><topic>Practice Patterns, Physicians' - standards</topic><topic>Questionnaires</topic><topic>Referral and Consultation</topic><topic>Rehabilitation</topic><topic>Rehabilitation Medicine</topic><topic>Retrospective Studies</topic><topic>Surveys and Questionnaires</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cheville, A. L.</creatorcontrib><creatorcontrib>Beck, L. A.</creatorcontrib><creatorcontrib>Petersen, T. L.</creatorcontrib><creatorcontrib>Marks, R. S.</creatorcontrib><creatorcontrib>Gamble, G. L.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Social Science Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Sociology Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Social Science Database</collection><collection>Sociology Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Supportive care in cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cheville, A. L.</au><au>Beck, L. A.</au><au>Petersen, T. L.</au><au>Marks, R. S.</au><au>Gamble, G. L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The detection and treatment of cancer-related functional problems in an outpatient setting</atitle><jtitle>Supportive care in cancer</jtitle><stitle>Support Care Cancer</stitle><addtitle>Support Care Cancer</addtitle><date>2009-01-01</date><risdate>2009</risdate><volume>17</volume><issue>1</issue><spage>61</spage><epage>67</epage><pages>61-67</pages><issn>0941-4355</issn><eissn>1433-7339</eissn><abstract>Goals of work
Cancer causes functional problems that are often neither detected nor treated in the outpatient setting. Patient–physician communication regarding functional issues may contribute. This study was conducted to quantify the degree of concordance between patient-identified functional problems and their documentation in the oncology-generated medical record.
Materials and methods
We administered a 27-item questionnaire addressing cancer-related symptoms, signs, and functional problems to a consecutive sample of 244 patients undergoing outpatient cancer treatment. Oncology clinician-generated notation in the electronic medical record (EMR) was systematically reviewed for documentation of the instrument items. EMR review began the day of instrument completion and extended retrospectively for 6 months.
Main results
Eighty-three percent (202) completed the survey with at least one cancer-related symptom, sign, or functional problem identified by 71.8%, 33.2% and 65.8% of patients, respectively. Difficulty with ambulation (23.9%) and balance (19.4%) were the most frequent functional problems. Clinician notes referred to 49% of patients’ symptoms, but only 37% of their signs and 6% of their functional problems. Pain, weight loss, and nausea (ORs > 4.9,
p
< 0.004) were most likely to be documented while functional problems (OR 0.2,
p
< 0.0001) were the least likely to be noted. Two rehabilitation physician referrals were generated for pain and limb swelling, but no functional problems were formally addressed.
Conclusion
Functional problems are prevalent among outpatients with cancer and are rarely documented by oncology clinicians. A more aggressive search for, and treatment of, these problems may be beneficial for outpatients with cancer.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>18478275</pmid><doi>10.1007/s00520-008-0461-x</doi><tpages>7</tpages></addata></record> |
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| language | eng |
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| subjects | Activities of daily living Adult Aged Aged, 80 and over Ambulatory Care - standards Cancer Documentation Female Humans Male Medical records Medical Records Systems, Computerized - standards Medicine Medicine & Public Health Middle Aged Minnesota Nausea Neoplasms - complications Neoplasms - physiopathology Neoplasms - rehabilitation Nursing Nursing Research Oncology Original Article Pain Medicine Patients Practice Patterns, Physicians' - standards Questionnaires Referral and Consultation Rehabilitation Rehabilitation Medicine Retrospective Studies Surveys and Questionnaires Young Adult |
| title | The detection and treatment of cancer-related functional problems in an outpatient setting |
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