Supportive Care in Cancer

, Volume 21, Issue 7, pp 1955–1962 | Cite as

Symptom burden in palliative care patients: perspectives of patients, their family caregivers, and their attending physicians

  • Karin OechsleEmail author
  • Kathrin Goerth
  • Carsten Bokemeyer
  • Anja Mehnert
Original Article



The purpose of this study was to prospectively evaluate the perspectives of palliative care patients, their family caregivers, and their attending palliative care specialists on frequency, intensity, distress, and treatment requirement of the patient’s physical and psychological symptoms.

Patients and methods

Forty advanced cancer patients and their family caregivers were recruited through a palliative care inpatient ward within 24 h after admission. Patients, caregivers, and physicians completed a modified version of the Memorial Symptom Assessment Scale (including perceived treatment requirement).


Thirty-nine patients (98 %) suffered from at least one symptom frequently or almost constantly (median number 5; range, 0–9). Most frequent symptoms were lack of energy (95 %), tiredness (88 %), and pain (80 %), which were scored correspondingly by patients, caregivers, and physicians to be the most intensive, distressing, and treatment requiring. Treatment requirement was determined by symptom intensity or distress in patients and physicians, but by distress in caregivers. Significant differences in symptom burden between patients, caregivers, and physicians were found with regard to pain (p = .007), tiredness (p = .037), lack of energy (p < .05), anxiety (p < .05), and sadness (p < .05). Physicians underestimated 60 % of symptom dimensions, while the caregivers overestimated 77 %; however, overall median scoring differences were limited with −.10 (range, −.55 to +.25) between patients and physicians and +.33 (range, −.78 to +.61) between patients and family caregivers.


While physicians tended to underestimate, family caregivers tended to overestimate the patient’s symptoms. Therefore, adequate symptom treatment can only be successful in a close dialog between patients, their caregivers, and a multidisciplinary team.


Palliative care Physical symptoms Psychological symptoms Burden Distress Family caregiver Physician 


Conflict of interest

None of the authors have any conflict of interest. This study was performed without any external funding or financial sponsoring.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Karin Oechsle
    • 1
    Email author
  • Kathrin Goerth
    • 1
  • Carsten Bokemeyer
    • 1
  • Anja Mehnert
    • 2
    • 3
  1. 1.Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology, Hubertus Wald Tumor Centrum–University Cancer Center HamburgUniversity Medical Center Hamburg-EppendorfHamburgGermany
  2. 2.Institute and Outpatient Clinic of Medical PsychologyUniversity Medical Center EppendorfHamburgGermany
  3. 3.Section of Psychosocial Oncology, Department of Medical Psychology and Medical SociologyUniversity Medical CenterLeipzigGermany

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