1440 - How to improve the pain measurement in oncological day hospital (DH) patients

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Palliative and Supportive Care
Presenter Mary Cabiddu
Authors M. Cabiddu1, K.F. Borgonovo2, M. Ghilardi3, M. Cremonesi1, F. Petrelli4, F. Maspero1, S. Barni5
  • 1Medical Oncology Division, Azienda Ospedaliera Treviglio-Caravaggio, 24047 - Treviglio/IT
  • 2Oncologia Medica E Chemioterapia, A.O. Treviglio-Caravaggio, 24047 - Treviglio/IT
  • 3Medical Oncology Division, A.O. Trevilgio-Caravaggio, 24047 - Treviglio/IT
  • 4Uo Oncologia, Azienda Ospedaliera Treviglio-Caravaggio, IT-24047 - Treviglio/IT
  • 5Azienda Ospedaliera Treviglio-Caravaggio, 24047 - Treviglio/IT



Quite all cancer patients experience pain. The Pain Visual Analogic Scale (VAS) is a useful tool for pain evaluation in every kind of patient, independently of his level of schooling and compliance. Patients are often reluctant to communicate the pain they feel to oncologist. In 2011 we conducted a survey in our Day Hospital about discrepancies between the pain score measured by an oncologist and a nurse using VAS. We explored the possible reasons and tried to overcame this problem.

Materials and methods

From January 2010 to February 2011 we evaluated 1546 DH admissions in 154 patients. Pain was measured by both an oncologist and a nurse, using VAS. The discrepancies were defined by at least 2 points of difference on the VAS score. On May 2011 we explored the possible reasons of discrepancy and we organized internal meetings with all oncological staff involved in the pain evaluation to examine this problem. From July to December 2011 we performed a new evaluation of discrepancies between VAS score measured by oncologist and nurse in 194 patients for a total of 979 DH admission.


The characteristics of the two samples of patients were similar; the staff involved was the some too. In the first survey 43,2% of discrepancies were observed: in 9.4% of admissions the VAS score recorded by the oncologist was greater than that registered by the nurse; in 33.8% of admissions the opposite was noted. Overall the concordance between VAS score oncologist/nurse was of 56,8%. In the second survey the global discrepancies were only 18,6%, with 9% and 9,6% of discrepancies between the two measurements, with VAS score greater in nurse and oncologist evaluation, respectively.


Our results appeared to confirm the reluctance of patients to reveal their pain, especially to the oncologist. Sometimes the oncologists are more focused on cancer treatment than on supportive care, and the pain measurement is performed so fast that the patient is brought to minimize the real entity of pain. Team training is useful to improve patient's care and patient's management in an oncological staff.


All authors have declared no conflicts of interest.