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Psychological symptom burden associated with malignant wounds: Secondary analysis of a prospective cohort study

Published online by Cambridge University Press:  01 August 2023

Shigemasa Takamizawa Open the ORCID record for Shigemasa Takamizawa [Opens in a new window] ,
Hiroto Ishiki Open the ORCID record for Hiroto Ishiki [Opens in a new window] ,
Shunsuke Oyamada ,
Yuma Takeda ,
Daisuke Kiuchi ,
Koji Amano ,
Yosuke Matsuda ,
Naosuke Yokomichi ,
Hiroyuki Kohara  and
Kozue Suzuki
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Shigemasa Takamizawa
Affiliation:
Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
Hiroto Ishiki*
Affiliation:
Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
Shunsuke Oyamada
Affiliation:
Department of Biostatistics, JORTC Data Center, Tokyo, Japan
Yuma Takeda
Affiliation:
Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
Daisuke Kiuchi
Affiliation:
Department of Palliative Care, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
Koji Amano
Affiliation:
Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
Yosuke Matsuda
Affiliation:
Palliative Care Department, St. Luke’s International Hospital, Tokyo, Japan
Naosuke Yokomichi
Affiliation:
Division of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Japan
Hiroyuki Kohara
Affiliation:
Department of Internal Medicine, Hatsukaichi Memorial Hospital, Hiroshima, Japan
Kozue Suzuki
Affiliation:
Department of Palliative Care, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
Eriko Satomi
Affiliation:
Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
Masanori Mori
Affiliation:
Division of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Japan
*
Corresponding author: Hiroto Ishiki; Email: h.ishiki@03.alumni.u-tokyo.ac.jp
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Abstract

Objectives

Patients with malignant wounds suffer from physical and psychological symptom burden. Despite psychological support being required, the impact of malignant wounds on patients’ psychological distress is poorly investigated. We evaluated psychological distress associated with malignant wounds for patients at their end of life.

Methods

This study used the secondary analysis of the results of a large prospective cohort study, which investigated the dying process among patients with advanced cancer in 23 palliative care units in Japan. The primary outcome of this study was the prevalence of moderate to severe psychological symptom burden, evaluated by the Integrated Palliative Care Outcome Scale (IPOS)-feeling at peace scores of 2–4. In addition, the factors affecting psychological symptoms were investigated. The quality of death was also evaluated upon death using the Good Death Scale score.

Results

Out of the total 1896 patients, 156 had malignant wounds (8.2%). Malignant wounds were more common in female and young people. The breast, head, and neck were the most prevalent primary sites. More patients with malignant wounds had IPOS-feeling at peace scores of 2–4 than patients without malignant wounds (41.0% vs. 31.3%, p = 0.024). Furthermore, psychological distress was associated with moderate to severe IPOS-pain and the frequency of dressing changes. The presence of malignant wounds did not affect the quality of death.

Significance of results

This study showed increased psychological distress due to malignant wounds. Patients with malignant wounds require psychological support in addition to the treatment of physical symptoms for maintaining their quality of life.

Keywords

Good Death ScaleIntegrated Palliative Care Outcome ScaleMalignant woundPsychological distressQuality of life
Type
Original Article
Information
Palliative & Supportive Care , Volume 22 , Issue 2 , April 2024 , pp. 396 - 403
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Copyright
© The Author(s), 2023. Published by Cambridge University Press.

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