Errors in Symptom Intensity Self-Assessment by Patients Receiving Outpatient Palliative Care

Garyali, Anil; Palmer, J. Lynn; Yennurajalingam, Sriram; Zhang, Tao; Pace, Ellen; Bruera, Éduardo

doi:10.1089/jpm.2006.9.1059

Cited by 57 publications

(73 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Some participants, however, lacked sufficient knowledge in the interpretation of certain symptoms, particularly tiredness, drowsiness, shortness of breath, well-being, and appetite. Reported benefits of the tool mainly related to direct patient care (symptom monitoring, treatment planning, communication); however, the tool was also useful for administrative and These findings suggest that the interpretation of symptoms is potentially problematic, not only for patients, as previously reported in the literature [9,20,21,23,24], but also for HCPs. Study participants provided many valid descriptions for explaining symptoms to patients, illustrating the complex multidimensional nature of most symptoms [22].…”

Section: Discussionsupporting

confidence: 54%

“…We also considered concerns that were identified by patients in a think aloud study of the ESAS, in which they reported difficulties in interpretation of six of the nine symptoms [20]. The survey consisted of five sections: To assess HCP knowledge of the ESAS (Part 3), we examined the following three areas, which had previously been identified as problematic by patients [9,20]:…”

Section: Survey Designmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Different versions of the ESAS have been used in research studies [9][10][11][12]. Recent studies have indicated that patients may have difficulty understanding the terminology and correct use of the ESAS [9,[13][14][15]. Additionally, numerous studies have demonstrated the lack of agreement between HCP assessment of symptoms and patient self-report [13,[16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Health care providers’ use and knowledge of the Edmonton Symptom Assessment System (ESAS): is there a need to improve information and training?

Buttenschoen

Stephan²,

Watanabe

et al. 2013

Support Care Cancer

View full text Add to dashboard Cite

Objectives The ESAS is a clinical symptom assessment tool developed for patients receiving palliative care for pain and symptom control. Recent studies have indicated that patients have difficulty understanding terminology and correct use of the ESAS, and that they appreciate the presence of a health care provider (HCP) to assist with ESAS completion. As appropriate assessment translates into effective treatment, it is important that HCPs have a good understanding of the tool. The purpose of this study was to assess HCPs' use, knowledge, and training needs of the ESAS. Methods One hundred ninety-three HCPs in palliative care and chronic pain, who used the ESAS, were invited to participate in a survey. Results The response rate was 43 % (n =83), with 62 % nurses, 26 % physicians, and 12 % other specialties. Most participants were palliative care specialists (79 %). The majority (77 %) had a good understanding of the ESAS terms. Knowledge problems included distinguishing tiredness and drowsiness (25 %), interpreting shortness of breath as a combination of subjective and objective symptoms (19 %), not indicating current symptom level (14 %), and reverse scoring of well-being (13 %) and appetite (9 %). Reported challenges were misinterpretation of some ESAS terms, assessing patients with impaired communication, and lack of time and reliability of caregiver assessments. Participants offered suggestions regarding how their knowledge and use of the ESAS could be improved. Conclusions Suggestions for improving ESAS administration and training were to include term definitions and examples of how to ask about terms that might be challenging for patients. Furthermore, initial and ongoing training sessions might help to clarify issues with the tool.

show abstract

Section: Discussionsupporting

confidence: 54%

Section: Survey Designmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Health care providers’ use and knowledge of the Edmonton Symptom Assessment System (ESAS): is there a need to improve information and training?

Buttenschoen

Stephan²,

Watanabe

et al. 2013

Support Care Cancer

View full text Add to dashboard Cite

show abstract

“…More than 130 relevant articles and abstracts were identified, of which thirty-nine were primary studies published as complete peer-reviewed papers, representing 25 different institutions. Of the thirty-nine papers, thirteen were from Canada 6,11,[20][21][22][23][24][25][26][27][28][29][30] ; eight were from the United States [12][13][14]18,[31][32][33][34] ; eight were from Scandinavia (Sweden 15,[35][36][37] , Denmark [38][39] , Norway 40 , Finland 16 ); two were from Western Europe (Netherlands 41 , United Kingdom 42 ); five were from southern Europe (Switzerland 43 , Italy 17,[44][45][46] ); two were from Australia 47,48 ; and one was from Asia 49 .…”

Section: Methodsmentioning

confidence: 99%

A Review of the Reliability and Validity of the Edmonton Symptom Assessment System

2009

View full text Add to dashboard Cite

BackgroundSystematic symptom reporting by patients and the use of questionnaires such as the Edmonton Symptom Assessment System (ESAS) have potential to improve clinical encounters and patient satisfaction. We review findings from published studies of the ESAS to guide use of the system and to focus research. MethodsA systematic search for articles from 1991 through 2007 found thirty-nine peer-reviewed papers from 25 different institutions, thirty-three of which focused on patients with cancer. Observations, data, and statistics were collated according to relevance, reliability, validity, and responsiveness. ResultsFindings apply predominantly to symptomatic palliative patients with advanced cancer who were no longer receiving active oncologic therapies. Uncertainty about summarizing findings arises from frequent modification of the ESAS (altered items, scales, and time periods). Overall, reliability is established for daily administration. Scores are skewed, with a floor effect, but the relative order of symptoms by mean scores is similar across studies. Emotional symptoms are poorly captured by the depression and anxiety items. An equally weighted summation of scores may estimate a construct of "physical symptom distress," which in turn is related to performance status, palliative goals, quality of life, and well-being. ConclusionsThe ESAS is reliable, but it has restricted validity, and its use requires a sound clinical process to help interpret scores and to give them an appropriate level of attention. Research priorities are to further develop the ESAS for assessing a greater number of important physical symptoms (and to target "physical symptom

show abstract

Fear and pulmonary stress behaviors to an asphyxial threat across cognitive states

Campbell

2007

Research in Nursing & Health

View full text Add to dashboard Cite

The purpose of this exploratory study was to identify behaviors that may signify respiratory distress across cognitive states in response to an asphyxial threat. Patients undergoing a ventilator weaning trial were assessed and observed at baseline and during weaning with a capnograph/oximeter and video camera. Cognitive state was categorized at baseline, and an emotion report was elicited after the trial. Pulmonary stress and fear behaviors were similar across cognitive states. Hypercarbia predicted activation of fear behaviors. Gender differences characterized emotion reporting. An asphyxial threat may induce an innate array of behaviors that cannot be volitionally controlled and that may have the same appearance across cognitive states. Recognizing respiratory distress behaviors may improve nursing care of patients who are cognitively impaired.

show abstract

Errors in Symptom Intensity Self-Assessment by Patients Receiving Outpatient Palliative Care

Cited by 57 publications

References 22 publications

Health care providers’ use and knowledge of the Edmonton Symptom Assessment System (ESAS): is there a need to improve information and training?

Health care providers’ use and knowledge of the Edmonton Symptom Assessment System (ESAS): is there a need to improve information and training?

A Review of the Reliability and Validity of the Edmonton Symptom Assessment System

Fear and pulmonary stress behaviors to an asphyxial threat across cognitive states

Contact Info

Product

Resources

About