Cancer Care Professionals' Attitudes Toward Systematic Standardized Symptom Assessment and the Edmonton Symptom Assessment System After Large-Scale Population-Based Implementation in Ontario, Canada

Abstract

Findings show significant albeit variable uptake across disciplines in the use of the ESAS since program initiation. Several barriers to using the ESAS in daily practice were identified. These need to be addressed.

The Edmonton Symptom Assessment System 25 Years Later: Past, Present, and Future Developments

“…(75) A patient satisfaction survey involving 3660 patients in Ontario reported that a vast majority of patients (92%) agreed that the ESAS was important “as it helped their healthcare team to know their symptoms and severity”. (76)…”

“…(77) A subsequent survey of 2806 oncology professionals in Ontario (response rate 38%) also found that a majority of physicians (67%) and nurses (85%) perceived ESAS to be a useful starting point to assess patients’ symptoms. (76) 79% of physicians reported that they reviewed the ESAS scores at visits either “always” or “often”. However, a separate chart audit found that only 29% of patients with moderate-to-severe pain and 6% of patients with moderate-to-severe dyspnea had clinical actions documented in the chart, suggesting the need to strengthen the downstream actions from symptom screening through clinician education, resource allocation, and care pathways.…”

Enhancing clinical practice in the management of distress: The Therapeutic Practices for Distress Management (TPDM) project

“…In addition is the challenge of implementing evidence‐based psychosocial interventions . In one study, 30% of health care/medical professionals reported rarely or never looking at screening scores and only 60% discussed the scores with their patients . Screening alone is ineffective if the distress is not addressed with some form of psychosocial intervention …”

“…While attempts have been made to integrate distress management through screening programs, there is a discrepancy between the attitude and actual practice . Time, appropriate space needed to address private concerns and emotional distress identified in psychosocial screening, and skill are often cited as barriers by health care providers .…”

Early Palliative Care: Taking Ownership and Creating the Conditions

“…A case has also been made for a palliative care approach to be provided by family physicians 10 . Most oncologists and oncology nurses acknowledge a role in providing the palliative care approach to their patients 11 .…”