Italian version of the Edmonton Symptom Assessment System (ESAS)–Total Care (TC): development and psychometric validation in patients undergoing cancer treatment ... View Full Text


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Article Info

DATE

2021-10-08

AUTHORS

Carla Ripamonti, Rita Leporati, Giulia De Feo, Patricia Di Pede, Luisa Toffolatti, Mauro Guglielmo, Domenico La Carpia, Guido Miccinesi, Francesca Chiesi

ABSTRACT

IntroductionThe routine use of patient-reported outcomes (PROs) in clinical practice improves quality of care, it helps in reducing the access to emergency services and unscheduled visits, and it can improve cancer patients’ time survival. The Edmonton Symptom Assessment System (ESAS) is a PRO largely used in different care settings to monitor physical and psychological symptoms. Nonetheless, along with these symptoms, literature also highlighted the presence and effect of spiritual pain, financial distress, and social isolation on quality of care, treatment effectiveness, and survival.AimThe aims of the current study were (a) to complete the Italian version of the ESAS validation process by adding the missing symptom “insomnia” and (b) to develop and validate the ESAS–Total Care (ESAS-TC) that is intended to evaluate and screen not only physical and psychological symptoms but also spiritual pain, discomfort deriving from financial problems associated with illness, and suffering related to social isolation.MethodsA sample of Italian native outpatients, who referred to the dedicated Supportive Care Unit of the Fondazione IRCCS, Istituto Nazionale deiTumori (INT), Milano, were asked to fill the ESAS-TC to assess item properties, factorial structure, internal consistency, test–retest reliability (patients were asked to retake the scale after 2–6 weeks), and external validity. Concerning the latter, other self-administered scales were employed to assess perceived stress (Perceived Stress Scale), unmet needs (using theNeed Evaluation Questionnaire that describes informative, assistance/care, relational, needs for psycho-emotional support, material needs), and perceived social support (administering the Multidimensional Scale of Perceived Social Support that evaluates perceived support of family, friends, and significant others in the wider social field).ResultsThe scales were administered to 243 patients with solid (90%) and hematologic (10%) cancers, mean age 62.6, female 76.5%. Analysis suggested that a single factor better represents the structure of the ESAS scales, their internal consistency and test–retest reliability were good, and evidence of construct and criterion validity were provided. Additionally, incremental validity of the ESAS-TC was proved showing that the added items offer a unique contribution in predicting the patient’s stress. Finally, known groups validity was confirmed testing the differences in the ESAS scores due to the Karnofsky Performance Status.ConclusionsThe current study allowed to complete the validation of the Italian version of the ESAS and to develop a psychometrically sound scale, the ESAS-Total Care, that potentially helps in moving cancer research toward personalized total cancer care. More... »

PAGES

1-11

References to SciGraph publications

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  • 2019-01-08. Psychometric evaluation of three versions of the Italian Perceived Stress Scale in CURRENT PSYCHOLOGY
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    http://scigraph.springernature.com/pub.10.1007/s00520-021-06594-y

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    19 schema:datePublishedReg 2021-10-08
    20 schema:description Abstract IntroductionThe routine use of patient-reported outcomes (PROs) in clinical practice improves quality of care, it helps in reducing the access to emergency services and unscheduled visits, and it can improve cancer patients’ time survival. The Edmonton Symptom Assessment System (ESAS) is a PRO largely used in different care settings to monitor physical and psychological symptoms. Nonetheless, along with these symptoms, literature also highlighted the presence and effect of spiritual pain, financial distress, and social isolation on quality of care, treatment effectiveness, and survival.AimThe aims of the current study were (a) to complete the Italian version of the ESAS validation process by adding the missing symptom “insomnia” and (b) to develop and validate the ESAS–Total Care (ESAS-TC) that is intended to evaluate and screen not only physical and psychological symptoms but also spiritual pain, discomfort deriving from financial problems associated with illness, and suffering related to social isolation.MethodsA sample of Italian native outpatients, who referred to the dedicated Supportive Care Unit of the Fondazione IRCCS, Istituto Nazionale deiTumori (INT), Milano, were asked to fill the ESAS-TC to assess item properties, factorial structure, internal consistency, test–retest reliability (patients were asked to retake the scale after 2–6 weeks), and external validity. Concerning the latter, other self-administered scales were employed to assess perceived stress (Perceived Stress Scale), unmet needs (using theNeed Evaluation Questionnaire that describes informative, assistance/care, relational, needs for psycho-emotional support, material needs), and perceived social support (administering the Multidimensional Scale of Perceived Social Support that evaluates perceived support of family, friends, and significant others in the wider social field).ResultsThe scales were administered to 243 patients with solid (90%) and hematologic (10%) cancers, mean age 62.6, female 76.5%. Analysis suggested that a single factor better represents the structure of the ESAS scales, their internal consistency and test–retest reliability were good, and evidence of construct and criterion validity were provided. Additionally, incremental validity of the ESAS-TC was proved showing that the added items offer a unique contribution in predicting the patient’s stress. Finally, known groups validity was confirmed testing the differences in the ESAS scores due to the Karnofsky Performance Status.ConclusionsThe current study allowed to complete the validation of the Italian version of the ESAS and to develop a psychometrically sound scale, the ESAS-Total Care, that potentially helps in moving cancer research toward personalized total cancer care.
    21 schema:genre article
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    25 schema:keywords AimThe aim
    26 ConclusionsThe current study
    27 ESAS scale
    28 ESAS scores
    29 ESAS validation process
    30 ESAS-TC
    31 ESAS–Total Care
    32 Edmonton Symptom Assessment System
    33 Fondazione IRCCS
    34 IRCCS
    35 IntroductionThe routine use
    36 Istituto Nazionale deiTumori
    37 Italian native outpatients
    38 Italian version
    39 Karnofsky performance status
    40 Milano
    41 Nazionale deiTumori
    42 Symptom Assessment System
    43 Total Cancer Care
    44 access
    45 age 62.6
    46 aim
    47 analysis
    48 assessment system
    49 cancer
    50 cancer care
    51 cancer patients
    52 cancer research
    53 cancer treatment
    54 care
    55 care settings
    56 care unit
    57 clinical practice
    58 consistency
    59 constructs
    60 contribution
    61 criterion validity
    62 current study
    63 dedicated Supportive Care Unit
    64 deiTumori
    65 deriving
    66 development
    67 differences
    68 different care settings
    69 discomfort deriving
    70 distress
    71 effect
    72 effectiveness
    73 emergency services
    74 evidence
    75 evidence of construct
    76 external validity
    77 factorial structure
    78 factors
    79 financial distress
    80 financial problems
    81 group validity
    82 hematologic cancers
    83 illness
    84 incremental validity
    85 insomnia
    86 internal consistency
    87 isolation
    88 item properties
    89 items
    90 literature
    91 native outpatients
    92 need
    93 outcomes
    94 outpatients
    95 pain
    96 patient stress
    97 patient-reported outcomes
    98 patients
    99 performance status
    100 practice
    101 presence
    102 problem
    103 process
    104 properties
    105 psychological symptoms
    106 psychometric validation
    107 quality
    108 quality of care
    109 reliability
    110 research
    111 routine use
    112 samples
    113 scale
    114 scores
    115 screen
    116 self-administered scale
    117 services
    118 setting
    119 single factor
    120 social isolation
    121 social support
    122 sound scale
    123 spiritual pain
    124 status
    125 stress
    126 structure
    127 study
    128 suffering
    129 support
    130 supportive care unit
    131 survival
    132 symptoms
    133 system
    134 test-retest reliability
    135 time survival
    136 total care
    137 treatment
    138 treatment effectiveness
    139 unique contribution
    140 units
    141 unmet need
    142 unscheduled visits
    143 use
    144 validation
    145 validation process
    146 validity
    147 version
    148 visits
    149 schema:name Italian version of the Edmonton Symptom Assessment System (ESAS)–Total Care (TC): development and psychometric validation in patients undergoing cancer treatment or follow-up
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