Describing symptoms using the Symptom Screening in Pediatrics Tool in hospitalized children with cancer and hematopoietic stem cell transplant recipients (original) (raw)
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Validation of the Symptom Screening in Pediatrics Tool in Children Receiving Cancer Treatments
Journal of the National Cancer Institute, 2018
The objective was to evaluate the reliability and validity of the self-report Symptom Screening in Pediatrics Tool (SSPedi) from the perspective of children with cancer and pediatric hematopoietic stem cell transplant (HSCT) recipients. In this multicenter study, respondents were children age eight to 18 years who had cancer or had received HSCT, and their parents. Two different child respondent populations were targeted. More symptomatic respondents were receiving active treatment for cancer, admitted to the hospital, and expected to be in the hospital three days later. Less symptomatic respondents were in maintenance therapy for acute lymphoblastic leukemia or had completed cancer therapy. Children completed SSPedi and then responded to validated self-report measures of mucositis, nausea, pain, and global quality of life. Children in the more symptomatic group repeated SSPedi and a global symptom change scale three days later. Parent proxy-report was optional. Reliability was eval...
Journal of pain and symptom management, 2018
Primary objectives were to evaluate the interrater reliability and validity of proxy-report Symptom Screening in Pediatrics Tool (SSPedi) in children with cancer and pediatric hematopoietic stem cell transplant (HSCT) recipients. Secondary objective was to describe the interrater reliability of each SSPedi item. Respondents were children aged eight to 18 years with cancer or HSCT recipients, and their parents or guardians. We enrolled two pediatric respondent groups. The more symptomatic group was receiving active treatment for cancer, admitted to hospital, and expected to be in a hospital three days later. The less symptomatic group either was in maintenance therapy for acute lymphoblastic leukemia or had completed cancer treatments. Convergent validity was evaluated by comparing proxy-reported mucositis, nausea and vomiting, pain, and total SSPedi scores, with child self-reported validated scales, and we hypothesized fair correlations. Discriminant validity was evaluated by compar...
Symptom Evaluation in Pediatric Oncology Outpatient Setting; A Cross-Sectional Study
Iranian Journal of Pharmaceutical Sciences, 2019
Detection and management of cancer-related symptoms is a key component in children’s quality of life. We evaluate symptoms and their severity in Iranian pediatric oncology outpatients using Therapy-Related Symptom Checklist for Children (TRSC-C). This was a cross-sectional study conducted in two outpatient pediatric oncology settings. We included all patients aged between 5-17 years. The validated and reliable Persian translated version of TRSC-C was used to study the symptoms. Overall 1425 symptoms were documented from 162 patients (mean age 8.6 ±3.2, acute lymphoblastic leukemia: 76.5%). In 96.3% of patients at least one symptom was present. Twenty (12.34%) patients experienced at least 15 events. Irritable, loss of appetite, cough, pain and hair loss were the top 5 frequent symptoms. The highest mean severity scores were also belonged to irritable, loss of appetite, and hair loss. We found no significant difference between gender, age group or time of the last chemotherapy with m...
The Measurement of Symptoms in Children with Cancer
Journal of Pain and Symptom Management, 2000
The purpose of this study was to determine symptom prevalence, characteristics, and distress in children with cancer. The Memorial Symptom Assessment Scale (MSAS) 10-18, a 30-item patient-rated instrument adapted from a previously validated adult version, provided multidimensional information about the symptoms experienced by children with cancer. This instrument was administered to 160 children with cancer aged 10-18 (45 inpatients, 115 outpatients). To confirm the instrument's reliability and validity, additional data about symptoms were collected from both the parents and the medical charts, and retesting was performed on a subgroup of inpatients. Patients could easily complete the scale in a mean of 11 minutes. The analyses supported the reliability and validity of the MSAS 10-18 subscale scores as measures of physical, psychological, and global symptom distress, respectively. Symptom prevalence ranged from 49.7% for lack of energy to 6.3% for problems with urination. The mean ( Ϯ SD) number of symptoms per inpatient was 12.7 Ϯ 4.9 (range, 4-26), significantly more than the mean 6.5 Ϯ 5.7 (range, 0-28) symptoms per outpatient. Patients who had recently received chemotherapy had significantly more symptoms than patients who had not received chemotherapy for more than 4 months (11.6 Ϯ 6.0 vs. 5.2 Ϯ 5.1), and those patients with solid tumors had significantly more symptoms than patients with either leukemia, lymphoma, or central nervous system malignancies (9.9 Ϯ 7.0 vs. 6.8 Ϯ 5.5 vs. 6.8 Ϯ 5.0 vs. 8.0 Ϯ 6.1). The most common symptoms (prevalence Ͼ 35%) were lack of energy, pain, drowsiness, nausea, cough, lack of appetite, and psychological symptoms (feeling sad, feeling nervous, worrying, feeling irritable). Of the symptoms with prevalence rates Ͼ 35%, those that caused high distress in more than one-third of patients were feeling sad, pain, nausea, lack of appetite, and feeling irritable. Subscale scores demonstrated large variability in symptom distress and could identify subgroups with high distress. The prevalence, characteristics, and distress associated with physical and psychological symptoms could be quantified in older children with cancer. The data confirm a high prevalence of symptoms overall and the existence of subgroups with high distress associated with one or multiple symptoms. Symptom distress is relatively higher among inpatients, children with solid tumors, and children who are undergoing antineoplastic treatment. Systematic symptom assessment may be useful in future epidemiological studies of symptoms and in clinical chemotherapeutic trials. Symptom epidemiology may also provide a focus for future clinical trials related to symptom management in children with cancer.
A systematic review of symptom assessment scales in children with cancer
BMC Cancer
Background The objective was to describe symptom assessment scales that have been used in children with cancer. Methods We conducted electronic searches of OVID Medline and EMBASE in order to identify all symptom assessment scales that have been used in pediatric cancer. Two reviewers abstracted information from each identified study. Data collected included study demographics and information related to the instrument and children enrolled. We also collected information about the purpose of instrument administration and whether treatment was altered as a result of this information. Results Fourteen studies were identified which evaluated eight different symptom assessment scales. Eight studies used child self-report and all studies included children on active treatment for cancer although 4 studies also included children following completion of treatment. The most common purpose of instrument administration was to measure the prevalence of symptom burden (n = 8). None of the 14 stud...
2021
Background: Children undergoing cancer-directed treatment experience distressing symptoms. Multi-dimensional patient-reported symptom assessment scales have been validated in children with cancer, but are not routinely used in clinical practice.Aim: To describe the symptom prevalence and burden for children receiving treatment in a paediatric oncology unit, as described by both children where possible, and their parents.Methods: Prospective survey-based study during which the Memorial Symptom Assessment Scale was administered to children and parents. Participants were offered the opportunity to complete the survey on multiple occasions. Demographic and clinical data were obtained from electronic medical records. Institutional ethics approval was granted (HREC37022A).Results: Forty-one children were recruited, aged 8 months to 18 years and 54% were female. In total, 54 parent surveys and 29 child surveys were completed. The vast majority of surveys (81%) were completed in the inpatie...
Carolina Digital Repository (University of North Carolina at Chapel Hill), 2020
Purpose: Patients undergoing a hematopoietic stem cell transplantation (HCT) have varied symptoms during their hospitalization. This study examined whether daily symptom reporting (with electronic patient-reported outcomes [PROs]) in an inpatient bone marrow transplant clinic reduced symptom burden on post-transplant days +7, +10, and +14. A prospective, single-institution1:1 pilot randomized, two-arm study recruited HCT patients. HCT inpatients (N=76) reported daily on 16 common symptoms using the PRO version of the Common Terminology for Adverse Events (PRO-CTCAE). Fisher's exact test was used to examine differences in the proportion of patients reporting individual symptoms. Multivariable linear regression modeling was used to examine group differences in peak symptom burden, while controlling for symptom burden at baseline, age, comorbidity, and transplantation type (autologous or allogeneic). Results: HCT patients receiving the PRO intervention also experienced lower peak symptom burden (average of 16 symptoms) at days +7, +10, and +14 (10.4 vs 14.5, p =0.03). Conclusions: Daily use of electronic symptom reporting to nurses in an inpatient bone marrow transplant clinic reduced peak symptom burden and improved individual symptoms during the two weeks post-transplant. A multi-site site trial is warranted to demonstrate the generalizability, efficacy, and value of this intervention.
Refinement of the Symptom Screening in Pediatrics Tool (SSPedi)
British Journal of Cancer, 2014
Background: Objective was to evaluate and refine a new instrument for paediatric cancer symptom screening named the Symptom Screening in Pediatrics Tool (SSPedi). Methods: Respondents were children 8-18 years of age undergoing active cancer treatment and parents of eligible children. Respondents completed SSPedi once and then responded to semi-structured questions. They rated how easy or difficult SSPedi was to complete. For items containing two concepts, we asked respondents whether concepts should remain together or be separated into two questions. We also asked about each item's importance and whether items were missing. Cognitive probing was conducted in children to evaluate their understanding of items and the response scale. After each group of 10 children and 10 parents, responses were reviewed to determine whether modifications were required. Recruitment ceased with the first group of 10 children in which modifications were not required. Results: Thirty children and 20 parents were required to achieve a final version of SSPedi. Fifteen items remain in the final version; the score ranges from 0 to 60. Conclusions: Using opinions of children with cancer and parents of paediatric cancer patients, we successfully developed a symptom screening tool that is easy to complete, is understandable and demonstrates content validity. Cure rates for paediatric cancer are approaching 82% (Canadian Cancer Society's Steering Committee on Cancer Statistics, 2011) but the costs of this progress include a high frequency and intensity of symptoms during treatment (Baggott et al, 2010; Poder et al, 2010; Miller et al, 2011) and chronic health conditions following completion of treatment (Oeffinger et al, 2006). In general, the symptom burden in children undergoing treatment for cancer is very high (Baggott et al, 2010; Poder et al, 2010; Miller et al, 2011). Active symptom screening is important because children undergoing cancer treatment may not voice concerns or complain.
Research Square (Research Square), 2022
Background: Children undergoing cancer-directed treatment experience distressing symptoms. Multidimensional patient-reported symptom assessment scales have been validated in children with cancer, but are not routinely used in clinical practice. Aim: To describe the symptom prevalence and burden for children receiving treatment in a paediatric oncology unit, as described by both children where possible, and their parents. Methods: Prospective survey-based study during which the Memorial Symptom Assessment Scale was administered to children and parents. Participants were offered the opportunity to complete the survey on multiple occasions. Demographic and clinical data were obtained from electronic medical records. Results: Forty-one children were recruited, aged 8 months to 18 years and 54% were female. In total, 54 parent surveys and 29 child surveys were completed. The vast majority of surveys (81%) were completed in the inpatient setting, and more than half within 10 days of chemotherapy. Haematological malignancies predominated. There was a median of 4.8 months between diagnosis and recruitment. Eleven children died after the study closed; no patients died during the study period. Symptom prevalence did not always correlate with distress. Conclusions: Exploration of the impact of a symptom, and not just its presence, is vital for patient-centred care and can be achieved using multi-dimensional symptom scales. Both the child and caregiver's voices should be obtained where possible. Further studies are needed to explore how these scales can be used to identify distress and guide supportive care delivery.