Validation of the Symptom Screening in Pediatrics Tool in Children Receiving Cancer Treatments

Abstract

BackgroundThe objective was to evaluate the reliability and validity of the self-report Symptom Screening in Pediatrics Tool (SSPedi) from the perspective of children with cancer and pediatric hematopoietic stem cell transplant (HSCT) recipients.MethodsIn this multicenter study, respondents were children age eight to 18 years who had cancer or had received HSCT, and their parents. Two different child respondent populations were targeted. More symptomatic respondents were receiving active treatment for cancer, admitted to the hospital, and expected to be in the hospital three days later. Less symptomatic respondents were in maintenance therapy for acute lymphoblastic leukemia or had completed cancer therapy. Children completed SSPedi and then responded to validated self-report measures of mucositis, nausea, pain, and global quality of life. Children in the more symptomatic group repeated SSPedi and a global symptom change scale three days later. Parent proxy-report was optional. Reliability was evaluated using intraclass correlations while convergent validity was evaluated using Spearman correlations.ResultsOf 502 children enrolled, 302 were in the more symptomatic group and 200 were in the less symptomatic group. Intraclass correlation coefficients were 0.88 (95% confidence interval [CI] = 0.82 to 0.92) for test-retest reliability and 0.76 (95% CI = 0.71 to 0.80) for inter-rater reliability. The mean difference in SSPedi scores between more and less symptomatic groups was 7.8 (95% CI = 6.4 to 9.2). SSPedi was responsive to change in global symptoms. All hypothesized relationships among measures were observed.ConclusionsSSPedi is a self-report symptom bother tool for children with cancer and HSCT recipients that is reliable, valid, and responsive to change. SSPedi can be used for clinical and research purposes. Future work should focus on integration into care delivery.

Describing symptoms using the Symptom Screening in Pediatrics Tool in hospitalized children with cancer and hematopoietic stem cell transplant recipients

“…At enrollment, the most common symptoms of any degree of bother were feeling tired (n = 271, 89.7%), feeling more or less hungry than you usually do (n = 233, 77.2%) and changes in taste (n = 182, 60.3%). As previously described [10], the most common severely bothersome symptoms were feeling tired (n = 99, 32.8%), feeling more or less hungry than you usually do (n = 75, 24.8%), hurt or pain (other than headache) (n = 43, 14.2%), and changes in taste (n = 43, 14.2%). Table 1 shows the characteristics of the entire cohort and stratified by the 181 participants who reported at least one severely bothersome symptom and the 121 who reported no severely bothersome symptoms.…”

“…Among the 302 patients, 298 (98.7%) reported having at least one symptom of any degree of bother (≥ score of 1) and 181 (59.9%) had at least one symptom scored as "a lot bothered" or "extremely bothered" (score of 3 or 4) at enrollment. The median total SSPedi score at enrollment was 12 (interquartile range (IQR) [8][9][10][11][12][13][14][15][16][17][18][19]). There were 282/302 (93.4%) children who completed SSPedi 3 days later and the median total SSPedi score was 9 (IQR 5-15).…”

Risk factors for chemotherapy‐induced nausea in pediatric patients receiving highly emetogenic chemotherapy

“…Nausea involves dynamic interactions between the central and autonomic nervous systems as well as gastric dysrhythmias and the endocrine system . Although the use of effective antiemetic agents has resulted in improved control of chemotherapy‐induced vomiting, chemotherapy‐induced nausea (CIN) continues to be a common negative influence on the quality of life of both adult and pediatric patients …”

“…1 Although the use of effective antiemetic agents has resulted in improved control of chemotherapy-induced vomiting, chemotherapy-induced nausea (CIN) continues to be a common negative influence on the quality of life of both adult and pediatric patients. 2,3 In addition to the inherent emetogenicity of chemotherapy, patient-related factors that place adult patients at increased risk of chemotherapy-induced vomiting and CIN have been identified. Riskadapted antiemetic prophylaxis in patients receiving chemotherapy may increase the likelihood of complete nausea and vomiting control.…”

Identifying clinical practice guidelines for the supportive care of children with cancer: A report from the Children's Oncology Group

“…[1,2] Despite large improvements in survival outcomes for children with cancer, patients experience a high burden of expected treatment-related and disease-related symptoms. [3–5] Across diverse clinical domains, delivering care consistent with clinical practice guideline (CPG) recommendations improves outcomes. [6–10] As such, provision of evidence-based supportive care to children with cancer has the potential to optimize treatment outcomes and improve quality of life.…”