Pereira José L, Chasen Martin R, Molloy Sean, Amernic Heidi, Brundage Michael D, Green Esther, Kurkjian Serena, Krzyzanowska Monika K, Mahase Wenonah, Shabestari Omid, Tabing Reena, Klinger Christopher A
University of Ottawa, Ottawa, Ontario, Canada; Bruyère Continuing Care, Ottawa, Ontario, Canada; Bruyère Research Institute, Ottawa, Ontario, Canada.
University of Ottawa, Ottawa, Ontario, Canada; Bruyère Continuing Care, Ottawa, Ontario, Canada.
J Pain Symptom Manage. 2016 Apr;51(4):662-672.e8. doi: 10.1016/j.jpainsymman.2015.11.023. Epub 2015 Dec 30.
Cancer patients experience a high symptom burden throughout their illness. Despite this, patients' symptoms and needs are often not adequately screened for, assessed, and managed.
This study investigated the attitudes of cancer care professionals toward standardized systematic symptom assessment and the Edmonton Symptom Assessment System (ESAS) and their self-reported use of the instrument in daily practice in a large healthcare jurisdiction where this is routine.
A 21-item electronic survey, eliciting both closed and open-ended anonymous responses, was distributed to all 2806 cancer care professionals from four major provider groups: physicians, nurses, radiotherapists, and psychosocial oncology (PSO) staff at the 14 Regional Cancer Centres across Ontario, Canada.
A total of 1065 questionnaires were returned (response rate: 38%); 960 were eligible for analysis. Most respondents (88%) considered symptom management to be within their scope of practice. Sixty-six percent of physicians considered the use of standardized tools to screen for symptoms as "best practice," compared to 81% and 93% of nurses and PSO staff, respectively. Sixty-seven percent of physicians and 85% of nurses found the ESAS to be a useful starting point to assess patients' symptoms. Seventy-nine percent of physicians looked at their patient's ESAS scores at visits either "always" or "often," compared to 29%, 66%, and 89% of radiotherapists, PSO staff, and nurses, respectively. Several areas for improvement of ESAS use and symptom screening were identified.
Findings show significant albeit variable uptake across disciplines in the use of the ESAS since program initiation. Several barriers to using the ESAS in daily practice were identified. These need to be addressed.
癌症患者在整个病程中承受着较高的症状负担。尽管如此，患者的症状和需求往往未得到充分的筛查、评估和管理。
本研究调查了癌症护理专业人员对标准化系统症状评估及埃德蒙顿症状评估系统（ESAS）的态度，以及他们在一个将此作为常规操作的大型医疗辖区的日常实践中对该工具的自我报告使用情况。
一项包含21个条目的电子调查问卷被分发给加拿大安大略省14个区域癌症中心的四大主要医疗服务提供群体的所有2806名癌症护理专业人员，该问卷收集封闭式和开放式匿名回复。这四大群体包括医生、护士、放射治疗师和心理社会肿瘤学（PSO）工作人员。
共收回1065份问卷（回复率：38%）；其中960份符合分析条件。大多数受访者（88%）认为症状管理属于他们的执业范围。66%的医生认为使用标准化工具筛查症状是“最佳实践”，而护士和PSO工作人员的这一比例分别为81%和93%。67%的医生和85%的护士认为ESAS是评估患者症状的有用起点。79%的医生在每次就诊时“总是”或“经常”查看患者的ESAS评分，而放射治疗师、PSO工作人员和护士的这一比例分别为29%、66%和89%。研究还确定了ESAS使用和症状筛查几个需要改进的方面。
研究结果表明，自项目启动以来，ESAS在各学科的使用情况虽有差异，但采用率显著。研究还确定了在日常实践中使用ESAS的几个障碍。这些障碍需要得到解决。
