The Edmonton symptom assessment system-what do patients think?
The Edmonton symptom assessment system-what do patients think?
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DOI：
10.1007/s00520-008-0522-1
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发表时间：
2009-06-01
影响因子：
3.1
通讯作者：
Mawani, Asifa
中科院分区：
文献类型：
--
作者：
Watanabe, Sharon;Nekolaichuk, Cheryl;Mawani, Asifa
埃德蒙顿症状评估系统 (ESAS) 是一种自我报告症状强度的工具，最初是为晚期癌症患者开发的。它由九种常见症状的数字评定量表组成，并且可以选择添加第十种症状。尽管它在姑息治疗中广泛使用，但很少有研究关注其心理测量特性，没有涉及患者的观点。本研究的目的是通过检查患者在完成 ESAS 时的认知过程、对术语和数字评级的理解以及 ESAS 作为自我报告工具的意见，收集 ESAS 的有效性证据。招募了在癌症中心接受疼痛和症状控制咨询服务的讲英语的晚期癌症患者。采用定性“大声思考”研究设计，患者独立完成 ESAS，同时被提示说出他们的想法。然后，他们回答了一份结构化调查问卷，以征求他们对 ESAS 的看法。对录音记录进行了编码和分析。对二十名患者进行了评估。症状评级受到当前症状概况、时间变化、症状经历史和个人看法的影响。症状解释和数字评级分配各不相同。困难的术语包括疲劳与困倦、抑郁、焦虑、食欲和幸福感。大多数患者同意项目顺序，并认为 ESAS 很容易完成，并且有医疗保健专业人员在场。患者表示需要强调“现在”的时间范围。可能需要对工具和管理流程进行修改，但需要在其他人群中进行进一步研究。
The Edmonton Symptom Assessment System (ESAS) is a tool for self-reporting of symptom intensity, initially developed for advanced cancer patients. It consists of numerical rating scales for nine common symptoms, with the option of adding a tenth. Despite its widespread use in palliative care, few studies have focused on its psychometric properties, with none involving patient perspectives. The purpose of this study was to gather validity evidence for the ESAS, by examining patients' cognitive processes while completing the ESAS, understanding of terminology and numerical ratings, and opinions of the ESAS as a self-reporting tool.English-speaking advanced cancer patients, referred to a Pain and Symptom Control Consultation Service in a cancer centre, were recruited. Using a qualitative "think aloud" study design, patients completed the ESAS independently while being prompted to verbalize their thoughts. They then answered a structured questionnaire to elicit their opinions of the ESAS. Transcripts of audio-taped sessions were coded and analyzed.Twenty patients were evaluable. Symptom ratings were influenced by current symptom profiles, temporal changes, symptom experience history and individual perceptions. Symptom interpretation and numerical rating assignments varied. Difficult terminology included tiredness versus drowsiness, depression, anxiety, appetite, and well-being. Most patients agreed with the item order and thought that the ESAS was easy to complete, with a health care professional present. Patients expressed a need to emphasize the timeframe as "now".Modification of the tool and administration process may be warranted, but further study in other populations is needed.