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The purpose of this project was to develop the M. D. Anderson Symptom Inventory (MDASI), a brief measure of the severity and impact of cancer‐related symptoms. A list of symptoms was generated from symptom inventories and by panels of clinicians. Twenty‐six symptoms and 6 interference items were rated by a validation sample of 527 outpatients, a sample of 30 inpatients from the blood and bone marrow transplantation service, and a cross‐validation sample of 113 outpatients. Clinical judgement and statistical techniques were used to reduce the number of symptoms. Reliability, validity, and sensitivity of the MDASI were examined. Cluster analysis, best subset analysis, and clinical judgement reduced the number of symptoms to a “core” list of 13 that accounted for 64% of the variance in symptom distress. Factor analysis demonstrated a similar pattern in both outpatient samples, and two symptom factors and the interference scale were reliable. Expected differences in symptom pattern and severity were found between patients with “good” versus “poor” performance status and between patients in active therapy and patients who were seen for follow‐up. Patients rated fatigue‐related symptoms as the most severe. Groups of patients classified by disease or treatment had severe symptoms that were not on the “core” list. Conclude the core items of the MDASI accounted for the majority of symptom distress reported by cancer patients in active treatment and those who were followed after treatment. The MDASI should prove useful for symptom surveys, clinical trials, and patient monitoring, and its format should allow Internet or telephone administration.

Conducting a survey to identify nurses perceptions of research was useful in involving nurses in the conduct of research, and the results were useful guides to beginning a coordinated program of nursing research.

BACKGROUND Few studies have evaluated cognitive‐behavioral interventions as an adjunct treatment for chronic cancer‐related pain. A randomized clinical trial was performed evaluating the efficacy of 3 brief cognitive‐behavioral techniques: relaxation, distraction, and positive mood interventions. METHODS Fifty‐seven patients with chronic cancer‐related pain taking opioid medications were randomly assigned to either the relaxation, distraction, positive mood, or waiting‐list control group. The patients in the 3 intervention groups received audiotapes of the cognitive‐behavioral technique and were asked to practice regularly at home. The tapes were supplemented with written instructions and follow‐up telephone calls. RESULTS Patients in the relaxation and distraction groups reported significantly reduced pain intensity immediately after listening to the tapes. The pain reduction was not maintained, however. At the 2‐week follow‐up assessment, no significant differences in pain intensity or interference were found among the treatment groups. The groups also did not differ with regard to secondary outcome measures assessing quality of life, mood, self‐efficacy, and other symptoms. The results of qualitative interviews indicated that patients often had difficulty focusing on the audiotapes and preferred their own methods of pain reduction. CONCLUSIONS Brief relaxation and distraction audiotape interventions produced immediate pain reductions but not longer‐term pain relief. Additional research with a more individualized intervention is needed to evaluate cognitive‐behavioral interventions for cancer pain control. Cancer 2006. © 2006 American Cancer Society.

Objective: The M. D. Anderson Symptom Inventory (MDASI) and its modules measure common symptoms related to cancer and its treatment. We report the development and initial validation of the MDASI-Thyroid Cancer module (MDASI-THY). Methods: A list of thyroid-cancer-specific symptoms was generated through focus groups and interviews with thyroid cancer patients, clinicians and researchers. These MDASI-THY items were added to the original MDASI and administered to 60 patients with thyroid cancer. Symptom prevalence and severity were evaluated, along with the reliability and content, construct and known-group validity of the MDASI-THY. Results: Cognitive debriefing performed on a subset of patients indicated that the MDASI-THY items were clear, concise, relevant and easy to understand. Fatigue, drowsiness, sleep disturbance, distress and difficulty remembering were the 5 most prevalent and severe symptoms. Twenty-eight percent of patients had moderate to severe fatigue (≥5 on a 0–10 scale). Average severity was 1.28 and 1.29 for the symptom and interference subscales, respectively. MDASI-THY symptoms were severer for patients with poorer performance status. Cronbach α-values were 0.76, 0.85 and 0.92 for the thyroid-specific symptom items, core symptom subscale and interference subscale, respectively. Conclusions: This study demonstrates preliminary evidence for the validity and reliability of the MDASI-THY.