La cartella infermieristica permette una migliore valutazione dei sintomi nei pazienti oncologici

Background. A nurse Symptoms Assessment Chart (SAC) may represent a valuable tool to better address the clinical problems of cancer patients and to evaluate the needs related to both symptoms and adverse events of treatments. This retrospective survey was conducted to evaluate the usefulness of SAC in comparison with both medical records and QLQ-C30 questionnaire. Methods. Seven common symptoms (asthenia, dyspnoea, sleep disturbance, appetite disturbance, nausea or vomiting, diarrhoea and constipation) were evaluated. The results from SAC were integrated with patients' and physician's reports derived from QLQ-C30 selected items and visits records, respectively. Results. The individual data from 100 patients were surveyed. A full symptom description was reported in 95.5% versus 33.5% for SAC and medical records respectively. As compared with the patient opinion (QLQ-C30), the accuracy of SAC was > 80% for asthenia, constipation, diarrhoea, nausea/vomiting and appetite disturbance, and > 70% for dyspnoea and sleep disturbance. The accuracy of medical records, however, was usually lower except for dyspnoea, asthenia and constipation. Agreement on the presence of symptoms between QLQ-C30 and SAC was found to be moderate (k correlation >0.40) for 5 out of 7 symptoms evaluated. Discussion. The SAC has demonstrated to identify the patients' symptoms and their severity showing a greater coherence with QLQ-C30 as compared to medical records. A closer integration between physician and nurse's tools is needed to better address the cancer's patients needs.