부산대학교 도서관

The Joan Karnell Cancer Center at Pennsylvania Hospital is participating in a quality improvement initiative called AIM Higher, designed to improve assessment, information provision and management of cancer related symptoms. It uses a computerized assessment tool called the Patient Care Monitor administered on a portable computer called the e/tablet. Patients rate the severity of their cancer related physical and psychological symptoms on a 0-10 scale. It appears that younger patients experience a greater degree of symptom distress than their older counterparts. To determine if there is a difference in patient reported symptom severity between medical oncology patients over the age of 65 and under the age of 65 and develop age specific interventions to address these symptoms. Symptom scores from approximately 1650 patients, divided into five age categories were evaluated. 2-sample t-tests were utilized to determine if severity differences in the above and below 65 age groups were significant. 24 of the 36 physical symptoms and 10 of the 11 psychological ones were significant at the .05 level. However, it is possible that younger and older patients experience the same severity of symptoms, but that for whatever reason, younger patients perceive this severity more strongly and/or report it at a higher level. If this is the case, an older patient reporting a severity level of 4 may be experiencing a higher level of distress than a younger patient reporting a 5. Another series of t-tests, designed to account for these idiosyncrasies, was run and significant differences found in 15 physical and 4 psychological symptoms, including trouble sleeping, trouble concentrating, and being worried. A review of the literature on this topic also confirms numerous other studies in which younger cancer patients reported more difficulty with physical and psychological problems than older patients Reasons for these differences may include developmental stage of life and experience in coping with previous symptoms. Older patients may experience less distress (not severity) from common chemotherapy related symptoms. [ABSTRACT FROM AUTHOR]