Cancer patients' symptom reporting gaps in fatigue, pain, and emotional distress: a cross-sectional study of symptom management in China.

PURPOSE: This study examined the prevalence, reporting, and perceived management of fatigue, pain, and emotional distress among hospitalized patients with cancer in China and their associations with demographic, clinical, and laboratory characteristics.

METHODS

A cross-sectional study included 1,280 patients from secondary and tertiary hospitals across 16 cities in Shandong Province. Data were obtained through medical record review and patient questionnaires. Twelve binary symptom-related outcomes were assessed. Separate multivariable multilevel logistic regression models examined demographic and clinical characteristics and laboratory parameters, accounting for city-level clustering. Both sets of models included cancer type.

RESULTS

During the current hospitalization, 88%, 74%, and 94% of patients experienced fatigue, pain, and emotional distress, respectively. Among patients experiencing the corresponding symptom, reporting rates were 55%, 63%, and 40%. In the demographic and clinical models, male, unmarried, and divorced patients had lower odds of reporting all three symptoms than their respective reference groups. Among patients who discussed the respective symptom, male patients had higher odds of reporting definite receipt of desired help for all three symptoms than female patients. In the laboratory models, low neutrophil counts and high hemoglobin levels were associated with higher odds of reporting pain, whereas low potassium levels were associated with lower odds.

CONCLUSION

Symptom reporting was incomplete, particularly for emotional distress, highlighting the need for person-centered symptom assessment and communication. Among patients who discussed the respective symptom with a clinician, the proportion reporting definite receipt of desired help was highest for pain (97%), followed by fatigue (47%) and emotional distress (40%).