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The Role of a Symptom Assessment Tool in Shaping Patient-Physician Communication in Palliative Care.

Published on Jan 1, 2020in Journal of Pain and Symptom Management3.378
· DOI :10.1016/J.JPAINSYMMAN.2019.08.024
Joanna Veazey Brooks4
Estimated H-index: 4
(KU: University of Kansas),
Claire Poague (KU: University of Kansas)+ 2 AuthorsHeather V. Nelson-Brantley2
Estimated H-index: 2
(KU: University of Kansas)
Abstract
Abstract Context Patients with cancer experience many symptoms that disrupt quality of life, and symptom communication and management can be challenging. The Edmonton Symptom Assessment System (ESAS) was developed to standardize assessment and documentation of symptoms, yet research is needed to understand patients' and caregivers' experiences using the tool and its ability to impact patient-provider aligned care. Objectives The objective of this study was to understand how the ESAS shapes communication between patients and providers by exploring patients' and caregivers' experiences using the ESAS and assessing the level of agreement in symptom assessment between patients and palliative care physicians. Methods This study used a mixed-methods design. Thirty-one semistructured interviews were conducted and audio-recorded with patients (n = 18) and caregivers (n = 13). Data were analyzed following a social constructionist grounded theory approach. Patient and provider ESAS scores were obtained by medical chart review. Intraclass correlation coefficients were used to assess the level of agreement between patient-completed ESAS scores and provider-completed ESAS scores. Results Participants reported that the ESAS was a beneficial tool in establishing priorities for symptom control and guiding the appointment with the palliative care physician, despite challenges in completing the ESAS. Filling out the ESAS can also help patients more clearly identify their priorities before meeting with their physician. There was a good to excellent level of agreement between patients and physicians in all symptoms analyzed. Conclusion The ESAS is beneficial in enhancing symptom communication when used as a guide to identify and understand patients' main concerns.
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References36
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#1Lisa Barbera (TBCC: Tom Baker Cancer Centre)H-Index: 8
#2Rinku SutradharH-Index: 24
Last. Thiruchelvam DevaH-Index: 2
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Background: Cancer patients often present with several concurrent symptoms. There is evidence to suggest that related symptoms can cluster together in stable groups. The present study sought to identify symptom clusters in advanced cancer patients using the Edmonton Symptom Assessment System (ESAS) in a palliative outpatient radiotherapy clinic. Methods: Principal component analysis (PCA), exploratory factor analysis (EFA), and hierarchical cluster analysis (HCA) were used to identify symptom cl...
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#1Sherri Rauenzahn Cervantez (University of Texas Health Science Center at San Antonio)H-Index: 1
#2Laura LaNiel Tenner (University of Texas Health Science Center at San Antonio)H-Index: 3
Last. Savitri Singh-Carlson (SDSU: San Diego State University)H-Index: 1
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Background: The American Society of Clinical Oncology’s recommendation for “dedicated palliative care services, early in the disease course, concurrent with active treatment” for cancer patients is a challenge for cancer centers to accommodate. Despite demonstrated benefits of concurrent care, disparities among socioeconomic and ethnic groups in access to supportive care services have been described. The aim of this project was to evaluate: a) how insurance coverage and ethnicity impact patient ...
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#1Jun Kako (Hiroshima University)H-Index: 3
#2Masamitsu Kobayashi (National Defense Medical College)H-Index: 3
Last. Yoshihisa MatsumotoH-Index: 1
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Context:Terminally ill patients with cancer experience various physical and emotional symptoms that have a negative impact on quality of life and activities of daily living. Recently, revised Edmonton Symptom Assessment System (ESAS-r) scores have been proposed for assessing symptoms in terminally ill patients with cancer.Objective:To determine the optimal cutoff point for expressing ESAS-r scores as binary data, indicating the presence or absence of symptoms.Methods:We conducted a retrospective...
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#1Sorawit Boonyathee (MU: Mahidol University)H-Index: 1
#2Kittiphon Nagaviroj (MU: Mahidol University)H-Index: 3
Last. Thunyarat Anothaisintawee (MU: Mahidol University)H-Index: 15
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Background:Depression is a common health problem among patients with cancer. The Edmonton Symptom Assessment System (ESAS) is one of many tools that have been used to evaluate depression in these patients. Nevertheless, the diagnostic performance and the appropriate cutoff point of the ESAS for the assessment of depression in these patients have varied in the studies.Purpose:To determine the diagnostic accuracy and the optimal cutoff point for the ESAS for the assessment of depression in patient...
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#1Andreas JülichH-Index: 3
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An integrated multidisciplinary palliative care (IMPC) program is a promising tool to improve symptom control in patients at the end of life. The aim was to study the feasibility of the IMPC program in patients at the palliative care (PC) ward. A retrospective audit, using the extended Edmonton Symptom Assessment Scale (ESAS), was conducted on the PC ward of the university hospital. Consecutive patients who were admitted for the IMPC program during 1 year were considered. One hundred forty-eight...
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#1Donna Spaner (U of T: University of Toronto)H-Index: 1
#2Valerie B. Caraiscos (North York General Hospital)H-Index: 1
Last. Katherine Whitehead (U of T: University of Toronto)H-Index: 1
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Background:Optimal care for patients in the palliative care setting requires effective clinical teamwork. Communication may be challenging for health-care workers from different disciplines. Daily rounds are one way for clinical teams to share information and develop care plans for patients.Objective:The objective of this initiative was to improve the structure and process of daily palliative care rounds by incorporating the use of standardized tools and improved documentation into the meeting. ...
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Purpose:Research in palliative care demonstrates improvements in overall survival, quality of life, symptom management, and reductions in the cost of care. Despite the American Society of Clinical Oncology recommendation for early concurrent palliative care in patients with advanced cancer and high symptom burden, integrating palliative services is challenging. Our aims were to quantitatively describe the palliative referral rates and symptom burden in a South Texas cancer center and establish a...
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#1David S.C. Hui (University of Texas MD Anderson Cancer Center)H-Index: 76
#2BrueraEduardo (University of Texas MD Anderson Cancer Center)H-Index: 94
Abstract Context Routine symptom assessment represents the cornerstone of symptom management. Edmonton Symptom Assessment System (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. Objectives 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 be...
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#1Alexandra Vinson (NU: Northwestern University)H-Index: 2
Countervailing powers constrain the authority and autonomy of the medical profession. One countervailing power is patient consumerism, a movement with roots in health social movements. Patient empowerment discourses that emerge from health social movements suggest that active patienthood is a normative good, and that patients should inform themselves, claim their expertise, and participate in their care. Yet, little is known about how patient empowerment is understood by physicians. Drawing on e...
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