Saetra Pia, Fossum Mariann, Svensson Elisabeth, Cohen Marlene Z
Department of Health and Nursing Science, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway.
Sorlandet Hospital, Arendal, Norway.
J Clin Nurs. 2016 Mar;25(5-6):799-810. doi: 10.1111/jocn.13100. Epub 2016 Jan 27.
To evaluate the test-retest stability in assessments of perceived symptom intensity on the Edmonton Symptom Assessment System-revised and the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core 15 Palliative. The possible interchangeability between the instruments and the patients' experiences of completing the instruments were also studied.
The two instruments assess the same symptoms, but the symptom intensity is assessed on 11-point numerical scales on the Edmonton Symptom Assessment System-revised and on four-point verbal descriptive scales on the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core 15 Palliative. Both instruments are commonly used; however, uncertainty exists about which instrument should be recommended and about the interchangeability of the instruments.
This study used a test-retest design with inter-scale comparisons.
Data from 54 patients with cancer who were receiving palliative care in an oncology outpatient clinic were self-reported by the patients in the clinic, at home and when patients returned to the clinic.
The assessments on the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core 15 Palliative verbal rating scales showed a higher level of test-retest stability than the assessments on the Edmonton Symptom Assessment System-revised numerical scoring scales, indicating higher reliability. The correspondence between the verbal categories and the numerical scores of symptom intensity were low because different verbal categories were used by patients who assessed the same numerical score.
The test-retest stability in the assessments was higher on the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core 15 Palliative and the results show that assessments on the two instruments could not be used interchangeably. Therefore, the symptom instrument chosen must be specified and unchanged within a patient to improve efficacy in clinical practice.
The Edmonton Symptom Assessment System-revised or the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core 15 Palliative can be used for initial assessments of patients, but should not be compared or used interchangeably. It is vitally important to have individual follow-up for all patients who score an instrument.
评估修订版埃德蒙顿症状评估系统和欧洲癌症研究与治疗组织生活质量问卷核心15项姑息治疗版在感知症状强度评估中的重测稳定性。同时研究这两种工具之间可能的互换性以及患者填写这些工具的体验。
这两种工具评估相同的症状，但在修订版埃德蒙顿症状评估系统中症状强度通过11分数字量表进行评估，而在欧洲癌症研究与治疗组织生活质量问卷核心15项姑息治疗版中通过4分文字描述量表进行评估。这两种工具都被广泛使用；然而，对于应推荐哪种工具以及工具之间的互换性存在不确定性。
本研究采用重测设计并进行量表间比较。
54名在肿瘤门诊接受姑息治疗的癌症患者的数据由患者在诊所、家中以及返回诊所时自行报告。
欧洲癌症研究与治疗组织生活质量问卷核心15项姑息治疗版文字评定量表的评估显示出比修订版埃德蒙顿症状评估系统数字评分量表更高的重测稳定性，表明可靠性更高。症状强度的文字类别与数字分数之间的对应性较低，因为评估相同数字分数的患者使用了不同的文字类别。
欧洲癌症研究与治疗组织生活质量问卷核心15项姑息治疗版在评估中的重测稳定性更高，结果表明这两种工具的评估不能互换使用。因此，在患者个体内选择的症状评估工具必须明确且保持不变，以提高临床实践中的效果。
修订版埃德蒙顿症状评估系统或欧洲癌症研究与治疗组织生活质量问卷核心15项姑息治疗版均可用于患者的初始评估，但不应进行比较或互换使用。对所有使用某一工具进行评分的患者进行个体随访至关重要。
