Cancer symptom scale preferences: does one size fit all?

2016 ◽  
Vol 8 (2) ◽  
pp. 198-203 ◽  
Author(s):  
Kirby Jeter ◽  
Siobhan Blackwell ◽  
Lucy Burke ◽  
David Joyce ◽  
Catherine Moran ◽  
...  
Keyword(s):  
Rating Scale ◽  
Numerical Rating Scale ◽  
Eastern Cooperative Oncology Group ◽  
Symptom Assessment ◽  
Response Scale ◽  
Symptom Scale ◽  
Appetite Loss ◽  
Cancer Symptoms ◽  
Individual Scale ◽  
Loss Of Appetite

ObjectivesPatients with advanced cancer do not report all symptoms, so assessment is best done systematically. However, for such patients, completion rates of some symptom instruments are <50%. Symptoms can be quantified by various scales including the Categorical Response Scale (CRS), Numerical Rating Scale (NRS) and Visual Analogue Scale (VAS). Patient preferences for CRS, NRS and VAS in symptom assessment and their clinical utility in 3 cancer symptoms: pain, tiredness and appetite loss were determined.MethodsA prospective survey was conducted involving cancer admissions to a 36-bed palliative care unit.Results100 inpatients were recruited, aged 38–93 years (x̅ =71 years; SD=11.6), with median Eastern Cooperative Oncology Group (ECOG) scores of 2 (range 0–4). VAS was the least preferred measure. 52% of patients choose the same scale for all 3 symptoms and 44% for 2, with 4% choosing a different individual scale per symptom. There was moderate agreement between participant scale preference and observer determined ease of scale completion (loss of appetite: κ=0.36; pain: κ=0.49; tiredness: κ=0.45). Participants preferred CRS for appetite loss (48%) and tiredness (40%) and NRS for pain (44%).ConclusionsVAS was the least favoured scale and should be used cautiously in this population. Most participants had a scale preference with high intrapatient consistency between scales. CRS was preferred for appetite loss and tiredness and NRS for pain. Consideration should be given to individualised cancer symptom assessment according to patient scale preference.

Cancer symptom scale preference: One size to fit all?

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 69-69
Author(s):  
Brenda O'Connor ◽  
Kirby Jeter ◽  
Siobhan Blackwell ◽  
Lucy Burke ◽  
Emma Victoria Conway ◽  
...  
Keyword(s):  
Clinical Utility ◽  
Clinical Care ◽  
Symptom Assessment ◽  
Symptom Scale ◽  
Appetite Loss ◽  
Prospective Survey ◽  
Systematic Assessment ◽  
Numerical Rating ◽  
Categorical Response ◽  
Assessment Scales

69 Background: Systematic assessment in cancer is conducted by a variety of instruments. Such assessment is important as comprehensive instruments detect more symptoms than casual clinical evaluation. In choosing assessment scales for polysymptomatic cancer patients one must consider the burden of assessment to ensure satisfactory completion rates. This study investigated patient preference and clinical utility of symptom assessment scales. Methods: A prospective survey was conducted in an Irish palliative medicine inpatient unit.Consecutive cancer admissions were recruited within 7 days. Patients’ preferences were elicited with regards to 3 symptom assessment scales; categorical response (CRS), numerical rating (NRS), and visual analogue (VAS), across 3 common symptoms; appetite loss, pain, and tiredness. Participants selected their preferred scale per symptom. We determined the clinical utility of each scale, defined by ease of completion as judged by an observer. Results: 100 participants wererecruited,aged 38-93 years (x̅ = 71 years; SD=11.6). Median European Cooperative Oncology Group (ECOG) score was 2 (range 0-4). Participants preferred CRS for appetite loss (48%) and tiredness (40%), and NRS for pain (44%). VAS was consistently the least preferred measure. Scale preference was fully consistent across symptoms for 52% of patients, with just 4% choosing a different scale per symptom. There was moderate agreement between participant scale preference and ease of completion as determined by observer (Pain: K=0.486; Fatigue: K=0.452; Appetite loss K=0.364). Conclusions: (1) Most participants had a specific scale preference which was consistent across symptoms, (2) CRS was preferred overall, (3) Participants did not need to experience a symptom to have a preference, (4) VAS should be used with caution in hospice clinical care or research, (4) Symptom assessment scales should be carefully selected for clinical and research purposes.

scholarly journals Determinants of Pain Severity Changes in Ambulatory Patients With Cancer: An Analysis From Eastern Cooperative Oncology Group Trial E2Z02

2014 ◽  
Vol 32 (4) ◽  
pp. 312-319 ◽  
Author(s):  
Fengmin Zhao ◽  
Victor T. Chang ◽  
Charles Cleeland ◽  
James F. Cleary ◽  
Edith P. Mitchell ◽  
...  
Keyword(s):  
Pain Management ◽  
Pain Score ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Eastern Cooperative Oncology Group ◽  
Pain Severity ◽  
Initial Assessment ◽  
Pain Level ◽  
Ambulatory Patients

Purpose To understand changes in pain severity over time and to explore the factors associated with pain changes in ambulatory patients with solid tumors. Patients and Methods We enrolled 3,106 patients with invasive cancer of the breast, prostate, colon/rectum, or lung from multiple sites. At baseline and 4 to 5 weeks later, patients rated their pain level on a 0 to 10 numerical rating scale. A 2-point change in pain score was defined as a clinically significant change in pain. Multivariable logistic models were fitted to examine the effects of pain management and demographic and clinical factors on change in pain severity. Results We analyzed 2,761 patients for changes in pain severity. At initial assessment, 53.0% had no pain, 23.5% had mild pain, 10.3% had moderate pain, and 13.2% had severe pain. Overall, one third of patients with initial pain had pain reduction within 1 month of follow-up, and one fifth had an increase, and the improvement and worsening of pain varied by baseline pain score. Of the patients without pain at initial assessment, 28.4% had pain (8.9% moderate to severe) at the follow-up assessment. Logistic regression analysis showed that inadequate pain management was significantly associated with pain deterioration, as were lower baseline pain level, younger age, and poor health status. Conclusion One third of patients have pain improvement and one fifth experience pain deterioration within 1 month after initial assessment. Inadequate pain management, baseline pain severity, and certain patient demographic and disease characteristics are associated with pain deterioration.

Validation of the numerical rating scale versions of the Edmonton Symptom Assessment Aystem (ESAS) and ESAS-r among outpatients with advanced cancer.

2014 ◽  
Vol 32 (15_suppl) ◽  
pp. e20638-e20638
Author(s):  
Breffni Hannon ◽  
Martin Dyck ◽  
Ashley Pope ◽  
Nadia Swami ◽  
Christopher Lo ◽  
...  
Keyword(s):  
Advanced Cancer ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Symptom Assessment ◽  
Numerical Rating

scholarly journals Development and content validation of a symptom assessment for eosinophilic gastritis and eosinophilic gastroenteritis in adults and adolescents

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Calvin N. Ho ◽  
Sean O’Quinn ◽  
Julie Bailey ◽  
Oren Meyers ◽  
Ashley F. Slagle ◽  
...  
Keyword(s):  
Rating Scale ◽  
Numerical Rating Scale ◽  
Symptom Assessment ◽  
Eosinophilic Gastroenteritis ◽  
Symptom Improvement ◽  
Cognitive Debriefing ◽  
Validity And Reliability ◽  
Treatment Benefit ◽  
Eosinophilic Gastritis ◽  
Patient Reported

Abstract Background A patient reported outcome (PRO) instrument with evidence of validity and reliability for assessing symptoms of eosinophilic gastritis (EG) and eosinophilic gastroenteritis (EGE) is needed to measure treatment benefit in clinical trials. The aim of this research is to develop an EG/EGE symptom PRO instrument for patients aged 12 and above. Methods The Symptom Assessment for Gastrointestinal Eosinophilic Diseases (SAGED) was developed through a literature review, discussions with expert clinicians, and concept elicitation and cognitive debriefing interviews with patients. Patients (n = 28) were recruited based on confirmed diagnosis and self-reported symptoms. The final instrument was translated and linguistically validated with additional cognitive debriefing interviews (n = 105). Results SAGED is a 24-h recall questionnaire consisting of eight items evaluating the core symptoms of EG and EGE (abdominal pain, nausea, bloating, early satiety, loss of appetite, vomiting, and diarrhea). Seven of the eight items are evaluated on an 11-point numerical rating scale ranging from ‘none’ to ‘worst imaginable’. Cognitive debriefing interviews showed that adults and adolescents understand the content and are able to select a response that reflects their experience. The linguistic validation process produced 21 translations that are understandable to patients and conceptually equivalent to the source version. Conclusions SAGED is suitable for measuring symptom improvement in adult and adolescent patients with EG and/or EGE. The content validity of SAGED has been established through best practices in qualitative research for PRO instrument development. The psychometric properties of SAGED will be evaluated in a future study.

1215 Improving Sleep Disorders And Chronic Neck Pain By Adjusting Height Of The Pillow Through Cervical Posture Management

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A464-A464
Author(s):  
S Yamada ◽  
K Yamada
Keyword(s):  
Chronic Pain ◽  
Neck Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Somatic Symptoms ◽  
Chronic Neck Pain ◽  
Treatment Method ◽  
Symptom Scale ◽  
Sleeping Disorders ◽  
Cervical Posture

Abstract Introduction Recent studies have suggested that chronic musculoskeletal system pain, including chronic neck pain, accounts for approximately 70% of all sleeping disorders. Simultaneously, sleeping disorders increase pain sensitivity and create a vicious cycle of chronic neck pain. Patients with chronic pain experience a variety of somatic symptoms (e.g., Stomach or bowel problems, Back pain, Pain in your joints, headaches, chest pain, shortness of breath, dizziness, fatigue, and Trouble sleeping) that are difficult to treat. However, treatment of both neck chronic pain and sleeping disorders through cervical posture management by adjusting height of the pillow used while sleeping has yet to be considered. Methods Patients who visited our hospital with chief complaints of chronic neck pain were rated according to the Numerical Rating Scale (NRS) and were asked to answer the Somatic Symptom Scale-8 (SSS-8), to ascertain the degree of somatic symptoms. Out of all the patients, only 84 scored at least 8 out of 32 in the SSS-8. Based on the individual results of the 84 respondents, they were given customized pillows to be used for 3 months. The pillows were adjusted using the SSS method developed at our clinic. We adjusted the height of the pillow by 5mm increments to check the cervical inclination angle at approximately 15 degrees in supine position, lateral position with the center line from face to neck at left-right symmetry and finally confirming smooth turning over. The respondents performed NRS and SSS-8 after 2 weeks and 3 months of using the pillow. Results The results of this study showed that at 0 weeks / 2 weeks / 3 months. NRS score was 6.8 / 5.1 / 4.1 (p &lt;0.01), and the overall SSS-8 score was 13.2 / 9.9 / 8.2 (p &lt;0.01), showed a marked improvement. By symptom, all symptoms except Stomach or bowel problems showed significant improvement. Trouble sleeping showed the highest improvement at 2.6 / 1.7 / 1.3 (p &lt;0.01). Conclusion Chronic neck pain and sleeping disorders improved in the patients. These results suggested that cervical posture management by adjusting height of the pillow is an effective treatment method. Support None

Comparing the efficacy of nebulized morphine with intravenous morphine in traumatic musculoskeletal pain management

2020 ◽  
Vol 8 (1) ◽  
pp. 21-21
Author(s):  
Mani Mofidi ◽  
Ali Dashti ◽  
Mahdi Rezai ◽  
Niloufar Ghodrati ◽  
Hoorolnesa Ameli ◽  
...  
Keyword(s):  
Pain Management ◽  
Pain Relief ◽  
Musculoskeletal Pain ◽  
Normal Saline ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Vital Signs ◽  
Categorical Variables ◽  
Intravenous Morphine ◽  
Numerical Rating

Introduction: This study was designed to compare the effectiveness of intravenous morphine with nebulized morphine in pain relief of patients referring to the emergency setting with traumatic musculoskeletal pain. Methods: This randomized, placebo-controlled and double-blind clinical study evaluated 160 patients 18 to 65 years of age with acute traumatic pain, who attended the emergency department during 2019. Subjects were assessed with Numerical Rating Scale based on inclusion and exclusion criteria and randomly divided into two groups. In one group, 80 patients received IV morphine (0.1 mg/kg+5 mL normal saline) plus an equivalent volume of IV placebo. In the second group, 80 patients received nebulized morphine (0.2 mg/kg+5 mL normal saline) plus nebulized placebo. Pain score was monitored in all patients with Numerical Rating Scale before and after intervention at baseline, 15, 30, 45, and 60-minute intervals. Patients’ vital signs and possible adverse events were evaluated in each observation time points. Finally, all participants were assessed for their satisfaction with pain management. Data were analyzed using repeated measure analysis for continuous variables and Binomial test for categorical variables Results: There was no significant difference between the demographic characteristics of patients in study groups. Pain relief between the two groups was similar during the observation (0, 15, 30, 45, 60 min) (P>0.05). There were no changes in vital signs between two groups, although the nebulized group had lower systolic blood pressure at the time-point of 15 minutes after the treatment initiation (P=0.03). Conclusion: Although Nebulized morphine has similar efficacy in comparison with IV route, nebulization might be considered as the clinically efficacious route of morphine administration with minimal side effects, providing optimal pain relief in patients.

Comparison of Analgesic Effect of Levobupivacaine with Dexmedetomidine and Levobupivacaine for Scalp Block before Supratentorial Craniotomy: A Randomized Controlled Trial

2020 ◽  
Vol 103 (10) ◽  
pp. 1028-1035
Keyword(s):  
Postoperative Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Control Group ◽  
Study Group ◽  
Analgesic Requirement ◽  
Supratentorial Craniotomy ◽  
Numerical Rating ◽  
Fentanyl Consumption ◽  
Scalp Block

Background: Craniotomy causes acute and chronic pain. Uncontrolled postoperative pain may lead to adverse events. Perioperative scalp nerves block is not only effective in reducing intraoperative hemodynamic response, but it also reduces postoperative pain and postoperative analgesia requirement. Objective: To compare the benefits of adding dexmedetomidine to levobupivacaine in scalp nerves block before craniotomy for the duration of analgesia in supratentorial craniotomy. Materials and Methods: After approval by the Committee for Research, 50 supratentorial craniotomy patients were randomized into two groups. The control group received 30 mL scalp nerves block with 0.25% levobupivacaine with adrenaline 1:200,000, whereas the study group received 30 mL scalp nerves block with 0.25% levobupivacaine with adrenaline 1:200,000 plus dexmedetomidine 1 mcg/kg. The primary outcome was the time to first analgesic requirement postoperatively. The secondary outcomes included intraoperative fentanyl consumption, verbal numerical rating scale, tramadol consumption, and complications during the first 24 hours postoperatively. Results: Patients in the study group had significantly increase time to the first analgesic requirement in postoperative period and reduced intraoperative fentanyl consumption. The median time to first analgesic requirement was 555 (360 to 1,035) minutes in the study group versus 405 (300 to 520) minutes in the control group (p=0.023). Intraoperative fentanyl consumption 125 (75 to 175) mcg in the study group was significantly lower than 200 (150 to 250) mcg in the control group (p=0.02). The verbal numerical rating scale at 1, 4, 8, 12 and 24 hours postoperatively, tramadol consumption, and complications during the first 24 hours postoperatively were not statistically significant different. Conclusion: Preoperative scalp nerves block with 0.25% levobupivacaine with adrenaline (1:200,000) with dexmedetomidine 1 mcg/kg significantly increased the time to first analgesic requirement and reduced intraoperative fentanyl consumption compared to 0.25% levobupivacaine with adrenaline (1:200,000) without perioperative complications. Keywords: Scalp block, Dexmedetomidine, Post-craniotomy analgesia, Supratentorial tumor, Levobupivacaine

scholarly journals Ultrasound-guided superficial cervical plexus block for analgesia in patients undergoing craniotomy via suboccipital retrosigmoid approach: study protocol of a randomised controlled trial

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e034003
Author(s):  
Kun Peng ◽  
Min Zeng ◽  
Jia Dong ◽  
Xiang Yan ◽  
Dexiang Wang ◽  
...  
Keyword(s):  
Nerve Block ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Controlled Trial ◽  
Control Group ◽  
Cervical Plexus ◽  
Ethics Review ◽  
Superficial Cervical Plexus Block ◽  
Cervical Plexus Block ◽  
Plexus Block

IntroductionScalp nerve block has been proven to be an alternative choice to opioids in multimodal analgesia. However, for the infratentorial space-occupying craniotomy, especially the suboccipital retrosigmoid craniotomy, scalp nerve block is insufficient.Methods and analysisThe study is a prospective, single-centre, randomised, paralleled-group controlled trial. Patients scheduled to receive elective suboccipital retrosigmoid craniotomy will be randomly assigned to the superficial cervical plexus block group or the control group. After anaesthesia induction, superficial cervical plexus nerve block will be performed under the guidance of ultrasound. The primary outcome is the cumulative consumption of sufentanil by the patient-controlled intravenous analgesia pump within 24 hours after surgery. Secondary outcomes include the cumulative consumption of sufentanil at other four time points and numerical rating scale pain severity score.Ethics and disseminationThe protocol (version number: 2.0, 10 April 2019) has been approved by the Ethics Review Committee of China Registered Clinical Trials (Ethics Review No. ChiECRCT-20190047). The findings of this study will be disseminated in peer-reviewed journals and at scientific conferences.Trial registration numberNCT04036812

scholarly journals Application of 3D printing and framework internal fixation technology for high complex rib fractures

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Xuetao Zhou ◽  
Dongsheng Zhang ◽  
Zexin Xie ◽  
Yang Yang ◽  
Menghui Chen ◽  
...  
Keyword(s):  
3D Printing ◽  
Internal Fixation ◽  
Locking Plate ◽  
Rating Scale ◽  
Preoperative Planning ◽  
Numerical Rating Scale ◽  
Chest Ct ◽  
Rib Fractures ◽  
X Rays ◽  
With Screws

Abstract Objective To explore the clinical effect of 3D printing combined with framework internal fixation technology on the minimally invasive internal fixation of high complex rib fractures. Methods Total 16 patients with high complex rib fractures were included in the study. Before the procedure, the 3D rib model was reconstructed based on the thin-layer chest CT scan. According to the 3D model, the rib locking plate was pre-shaped, and the preoperative planning were made including the direction of the locking plate, the location of each nail hole and the length of the screw. During the operation, the locking plate was inserted from the sternum to the outermost fracture lines of ribs with screws at both ends. In addition, the locking plate was used as the frame to sequentially reduce the middle fracture segment and fix with screws or steel wires. Chest x-rays or chest CT scans after surgery were used to assess the ribs recovery. All patients were routinely given non-steroidal anti-inflammatory drugs (NSAIDS) for analgesia, and the pain level was evaluated using numerical rating scale (NRS). Results The preoperative planning according to the 3D printed rib model was accurate. The reduction and fixation of each fracture segment were successfully completed through the framework internal fixation technology. No cases of surgical death, and postoperative chest pain was significantly alleviated. Five to 10 months follow up demonstrated neither loosening of screws, nor displacement of fixtures among patients. The lungs of each patients were clear and in good shape. Conclusion The application of 3D printing combined with framework internal fixation technology to the high complex rib fractures is beneficial for restoring the inherent shape of the thoracic cage, which can realize the accurate and individualized treatment as well as reduces the operation difficulty.

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