Psychometric Validation of the Edmonton Symptom Assessment System in Chinese Patients

Dong, Yang; Chen, Heng; Zheng, Yuanyu; Guo, Ying; Kwon, Jung Hye; Liu, En; Guo, Hong; Bruera, Éduardo

doi:10.1016/j.jpainsymman.2015.05.018

Cited by 29 publications

(23 citation statements)

References 29 publications

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“…On the DT, participants evaluate an average week level of distress, whereas they report on a day level on the ESAS-r. As a consequence, higher sensitivity or lower stability is expected on the ESAS-r. The ESAS was originally designed to be used twice a day [ 12 ] and most studies investigating its stability have selected hours to days intervals [ 21 – 23 , 44 – 46 ]. This stresses the fact that lower stability over longer periods of time for such an instrument is a sought-after property as it may reflect sensitivity.…”

Section: Discussionmentioning

confidence: 99%

Stability and Repeatability of the Distress Thermometer (DT) and the Edmonton Symptom Assessment System-Revised (ESAS-r) with Parents of Childhood Cancer Survivors

et al. 2016

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ObjectiveParents report psychological distress in association with their child's cancer. Reliable tools are needed to screen parental distress over the cancer trajectory. This study aimed to estimate the stability and repeatability of the Distress Thermometer (DT) and the Depression and Anxiety items of the Edmonton Symptom Assessment System-revised (ESAS-r-D; -A) in parents of children diagnosed with cancer.MethodsFifty parents (28 mothers, median age = 44) of clinically stable survivors of childhood solid and brain tumours completed questionnaires about their own distress (DT, ESAS-r-D; -A, Brief Symptom Inventory-18: BSI-18, Patient Health Questionnaire-9: PHQ-9, Generalized Anxiety Disorder-7: GAD-7) and their children’s quality of life (QoL; Peds Quality of Life: PedsQL) twice, with a month interval between the two assessments. At retest, parents also evaluated life events that occurred between the two time points. Hierarchical regressions explored moderators for the temporal stability of test measures.ResultsStability estimates were ICC = .78 for the DT, .55 for the ESAS-r-D, and .47 for the ESAS-r-A. Caseness agreement between test and retest was substantial for the DT, fair for the ESAS-r-D, and slight for the ESAS-r-A. Repeatability analyses indicated that the error range for the DT was more than 2 pts below/above actual measurement, whereas it was more than 3 pts for the ESAS-r-A, and 2.5 for the ESAS-r-D. Instability of the DT could be explained by changes in children’s physical QoL, but not by other components of QoL or life events. No moderators of stability could be identified for the ESAS-r items.ConclusionsThe DT appears to be a fairly stable measure when the respondent's condition is stable yet with a relatively wide error range. Fluctuations in distress-related constructs may affect the temporal stability of the DT. The lower stability of ESAS-r items may result from shorter time-lapse instructions resulting in a greater sensitivity to change. Findings support future research on the DT as a reliable instrument in caregivers.

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Section: Discussionmentioning

confidence: 99%

Stability and Repeatability of the Distress Thermometer (DT) and the Edmonton Symptom Assessment System-Revised (ESAS-r) with Parents of Childhood Cancer Survivors

et al. 2016

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“…Multiple research groups have further validated ESAS both linguistically and psychometrically in Chinese,(26) Flemish,(27) French,(28) German,(29) Icelandic,(30) Italian,(31), Japanese,(32) Korean,(33) Portugese,(35) Spanish,(34) Thai,(36) and Turkish. (37) An Arabic variation of ESAS is also available.…”

Section: B Past Developmentsmentioning

confidence: 99%

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

Hui

Bruera

2017

Journal of Pain and Symptom Management

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534

428

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Context Routine symptom assessment represents the cornerstone of symptom management. ESAS is one of the first quantitative symptom assessment batteries that allows for simple and rapid documentation of multiple patient-reported symptoms at the same time. Objective To discuss the historical development of ESAS, its current uses in different settings, and future developments. Methods Narrative review Results Since its development in 1991, ESAS has been psychometrically validated and translated into over 20 languages. We will discuss the variations, advantages and limitations with ESAS. From the clinical perspective, ESAS is now commonly used for symptom screening and longitudinal monitoring in patients seen by palliative care, oncology, nephrology, and other disciplines in both inpatient and outpatient settings. From the research perspective, ESAS has offered important insights into the nature of symptom trajectory, symptom clusters and symptom modulators. Furthermore, multiple clinical studies have incorporated ESAS as a study outcome and documented the impact of various interventions on symptom burden. On the horizon, multiple groups are actively investigating further refinements to ESAS, such as incorporating it in electronic health records, employing ESAS as a trigger for palliative care referral, and coupling ESAS with personalized symptom goals to optimize symptom response assessment. Conclusion ESAS has evolved over the past 25 years to become an important symptom assessment instrument in both clinical practice and research. Future efforts are needed to standardize this tool and explore its full potential to support symptom management.

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“…[ 9 ] Previous studies examining the psychometrics of ESAS also confirmed the one-dimensional model. [ 10 13 14 16 18 ] However, despite the confirming psychometric properties of ESAS, Carvajal et al . used exploratory factor analysis in examining the factor structure of the tool and achieved three dimensions of soft physical, hard physical, and emotional components,[ 13 ] which was different from the one-dimensional factor structure introduced by Bruera et al .…”

Section: Discussion and C Onclusionsmentioning

confidence: 99%

“…[ 13 ] Due to its ease of use, ESAS was quickly used in palliative care and care programs for cancer patients and was adopted by different researchers in Spain, Italy, Thailand, Germany, Switzerland and China. [ 13 14 15 16 17 18 ] Dong et al . for instance evaluated the psychometric properties of ESAS in China and approved its criterion validity, internal consistency, and reliability.…”

Section: Introductionmentioning

confidence: 99%

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The psychometric properties and factor structure of persian version of edmonton symptom assessment scale in cancer patients

Khalili-Parapary

Heidarzadeh

Mozaffari

et al. 2017

Indian J Palliat Care

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Context:Edmonton Symptom Assessment Scale (ESAS) was developed to assess objective and subjective symptoms in patients with cancer in all stages of their disease.Aim:The aim of the study was to translate and determine the psychometric properties of ESAS in an Iranian population.Materials and Methods:The current study was carried out to determine reliability and validity of ESAS using 246 patients with cancer in Imam Khomeini Hospital, Ardabil, Iran. After translating the instrument to Persian, content and face validity, discriminant validity, internal consistency, and test-retest were done to determine psychometric properties of ESAS. Furthermore, the construct validity was determined using confirmatory factor analysis to evaluate factor structure of the tool in two models: single factor and three factor.Results:With regard to goodness of fit indices including comparative fit index, incremental fit index, and normed fit index, factor structure of ESAS was confirmed with one factor and nine items. Because the values of average variance extracted of each dimension were less than the square of correlation coefficients between the three dimensions of ESAS, three-factor model was not confirmed. Discriminant validity was confirmed by finding significant differences between the two groups, patients with good general and critically ill conditions. Cronbach's alpha for the overall ESAS was 0.88, and correlation between test-retest with 4–6 h interval was 0.86 (r = 0.86 P < 0001).Conclusions:This study showed that Persian version of ESAS with same factor structure mentioned in the original version is an applicable tool for assessing objective and subjective symptoms in Iranian patients with cancer.

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Psychometric Validation of the Edmonton Symptom Assessment System in Chinese Patients

Abstract: The C-ESAS is a good tool for measuring multidimensional symptoms in Chinese patients.

Cited by 29 publications

References 29 publications

Stability and Repeatability of the Distress Thermometer (DT) and the Edmonton Symptom Assessment System-Revised (ESAS-r) with Parents of Childhood Cancer Survivors

Stability and Repeatability of the Distress Thermometer (DT) and the Edmonton Symptom Assessment System-Revised (ESAS-r) with Parents of Childhood Cancer Survivors

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

The psychometric properties and factor structure of persian version of edmonton symptom assessment scale in cancer patients

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