The Symptom Prevalence and Relief of Symptoms in Cancer Patients with Nursing Healthcare-associated Pneumonia

Abstract

Background and Purpose: Nursing healthcare-associated pneumonia (NHCAP) causes distress and unpredictable symptoms. We investigated the frequency of comorbid symptoms and the effects of symptom relief with pharmacotherapy for NHCAP patients with advanced cancer. Methods: We retrospectively investigated the medical records of 15 patients with NHCAP who had died from January 2014 to November 2015. We investigated the frequencies of symptoms (pain, dyspnea, drowsiness, respiratory secretions, nausea, insomnia, fever, dry mouth, wheezing, and depression) and the therapeutic effects of drugs for symptom management (opiates, glucocorticoids, anti-cholinergic agents, and antibiotics). A Validated instruments (Support Team Assessment Schedule-Japan [STAS-J]) was used to assess symptom distress. Results: The symptoms of NHCAP were pain, insomnia, fever, fatigue, oral feeding difficulty, dry mouth, nausea, drowsiness, and depression. Administration of opioids was a useful treatment for dyspnea and pain. The mean number of concurrent symptoms was 4.6 ±1.8. Opioids and glucocorticoids were administrated to patients with pain and dyspnea, and these symptoms were resolved. Antibiotics were used in all patients, who were resolved their wheezing and fever, but no other symptoms. Conclusions: Patients with advanced cancer complicated by NHCAP have multiple distressing symptoms. A focus on ameliorating the most prevalent physical symptoms and psychological distress may improve overall quality of life in this patient population.