High Scores on the Edmonton Symptom Assessment Scale Identify Patients with Self-Defined High Symptom Burden

Selby, Debbie; Chakraborty, Anita; Myers, Jeff; Saskin, Refik; Mazzotta, Paolo; Gill, Ashlinder

doi:10.1089/jpm.2011.0187

Cited by 38 publications

(28 citation statements)

References 33 publications

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“…Policy development of this nature is occurring against a backdrop of global ageing, a rising prevalence of frailty and co-morbidity in chronic illness [3]. Meeting the palliative needs of such diverse populations is challenging and is made more difficult with growing evidence that patients face significant physical and psychological burden [4]. Elevated prevalence of psychological and physical burdens towards the end of life have been noted in patients with cancer [5], chronic kidney disease [6], COPD [7] and heart failure [8].…”

Section: Introductionmentioning

confidence: 99%

Symptom burden, palliative care need and predictors of physical and psychological discomfort in two UK hospitals

et al. 2013

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BackgroundThe requirement to meet the palliative needs of acute hospital populations has grown in recent years. With increasing numbers of frail older people needing hospital care as a result of both malignant and non-malignant conditions, emphasis is being placed upon understanding the physical, psychological and social burdens experienced by patients. This study explores the extent of burden in two large UK hospitals, focusing upon those patients who meet palliative care criteria. Furthermore, the paper explores the use of palliative services and identifies the most significant clinical diagnostic and demographic factors which determine physical and psychological burden.MethodsTwo hospital surveys were undertaken to identify burden using the Sheffield Profile for Assessment and Referral to Care (SPARC). The Gold Standards Framework (GSF) is used to identify those patients meeting palliative care criteria. Participants were identified as being in-patients during a two-week data collection phase for each site. Data was gathered using face-to-face interviews or self-completion by patients or a proxy. Descriptive analyses highlight prevalence and use of palliative care provision. Binary logistic regression assesses clinical diagnostic predictor variables of physical and psychological burden.ResultsThe sample consisted of 514 patients and elevated physical, psychological and social burden is identified amongst those meeting palliative care criteria (n = 185). Tiredness (34.6%), pain (31.1%), weakness (28.8%) and psychological discomfort (low mood 19.9%; anxiety 16.1%) are noted as being prevalent. A small number of these participants accessed Specialist Palliative Care (8.2%). Dementia was identified as a predictor of physical (OR 3.94; p < .05) and psychological burden (OR 2.88; p < .05), being female was a predictor of psychological burden (OR 2.00; p < .05).ConclusionThe paper highlights elevated levels of burden experienced by patients with palliative care requirements. Moreover, the paper also indicates that a large proportion of such patients are not in receipt of palliative approaches to their care. Furthermore, the paper identifies that those with non-malignant illnesses, especially dementia, may experience high levels of physical and psychological burden.

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Section: Introductionmentioning

confidence: 99%

Symptom burden, palliative care need and predictors of physical and psychological discomfort in two UK hospitals

et al. 2013

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“…Other studies found no significant correlation between symptom burden and PS of advance cancer patients 32,33 . Fu et al studied the relationship between symptom burden (using the ESAS) and the functional status (using the Functional Independence Measure [FIM]) of cancer patients in a rehabilitation unit 32 .…”

Section: Esas Itemmentioning

confidence: 86%

“…The average PPS score in their study was much higher than that in our study (69 vs. 36, respectively). They found no significant relationship between symptom burden and PS 33 . The latter two studies included patients with less symptom burden and better PS compared to our study.…”

Section: Esas Itemmentioning

confidence: 92%

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The Relationship between Distressing Symptoms and Performance Status among Cancer Patients Receiving Palliative Care

Hussenein

Hashem

Hadary

et al. 2017

Kasr-Al-Aini J.of Clin. Onc. and Nuc. Med.

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Background:Patients with advanced cancer experience distressing symptoms and progressive decline in their performance status (PS) as death approaches. Aim: To identify the relationship between symptom burden and PS of Egyptian cancer patients receiving palliative care. Methods: This was a prospective observational study that included 100 patients with advanced cancer. Symptom burden was assessed using the Arabic version of the revised Edmonton Symptom Assessment System (ESAS-r). Performance status was assessed using the Palliative Performance Scale (PPS). Results:The mean total ESAS-r score was 60.1 (±10.7). The most common symptom to be reported as severe was pain (93%) followed by tiredness (74%), poor wellbeing (67%), lack of appetite (62%), anxiety (60%) and drowsiness (56%). The majority of patients (76%) had a PPS score ≤30 with an overall mean PPS score of 36.2 (±13.3). There was a statistically significant negative correlation between the total ESAS score and the PPS score (r = -0.687, p = < 0.001). Conclusion:The results suggest that Egyptian patients with advanced cancer experience high symptom burden and significant decline in PS. The higher the symptom burden, the poorer the PS of patients with advanced cancer.

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“…They did not, however, consider other possible explanations for these high ratings, such as expected changes associated with advancing disease or patient preferences. In some cases, patients may rate their symptoms high, yet also view this as being a preferred or acceptable level of symptom control [25]. Attitudinal issues included viewing routine assessments as "unnatural" or burdensome for patients [15,28], or preferences to use one's own symptom assessments [29].…”

Section: Discussionmentioning

confidence: 99%

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

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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.

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High Scores on the Edmonton Symptom Assessment Scale Identify Patients with Self-Defined High Symptom Burden

Cited by 38 publications

References 33 publications

Symptom burden, palliative care need and predictors of physical and psychological discomfort in two UK hospitals

Symptom burden, palliative care need and predictors of physical and psychological discomfort in two UK hospitals

The Relationship between Distressing Symptoms and Performance Status among Cancer Patients Receiving Palliative Care

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

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