Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 686 Bay Street, Toronto, Ontario, M5G 0A4, Canada.
Division of Haematology/Oncology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada.
Eur J Cancer. 2019 Mar;109:120-128. doi: 10.1016/j.ejca.2019.01.002. Epub 2019 Feb 1.
Objectives were to describe the proportion of bothersome symptoms self-reported using the Symptom Screening in Pediatrics Tool (SSPedi) documented in the medical records and associated with an intervention.
Eligible respondents were inpatients aged 8-18 years receiving cancer treatments and expected to be in hospital or clinic three days later. Children self-reported symptom bother using SSPedi. We evaluated symptom documentation and interventions in the medical records proximal to SSPedi administration.
There were 168 children included. Symptoms rated as at least 'a lot' bother were documented in the medical record less than 60% of the time for 12 of 15 symptoms. Of these symptoms, the most infrequently documented symptoms were problems with thinking or remembering things (0%), changes in how your body or face look (4.8%), changes in taste (7.7%) and tingly or numb hands or feet (11.1%). Intervention provision for symptoms rated as 'a lot' bother occurred less than 60% of the time for 10 of 15 symptoms. Of these symptoms, the most infrequently treated were thinking or remembering things (0%), changes in how your body or face look (0%), tingly or numb hands or feet (0%), changes in taste (0%), diarrhoea (0%) and feeling tired (1.6%).
Documentation of symptoms and intervention provision were generally infrequent. Symptoms that were almost never documented or treated included problems with cognition, body image, taste changes and peripheral neuropathy. Future efforts should incorporate symptom screening into routine care and facilitate symptom management by improving access to evidence-based clinical practice guidelines.
本研究旨在描述使用儿科症状筛查工具（SSPedi）报告的烦扰症状的比例，并分析其与干预措施的相关性。
纳入对象为正在接受癌症治疗且预计在 3 天后住院或门诊的 8-18 岁住院患儿。患儿使用 SSPedi 自评症状困扰程度。我们评估了 SSPedi 评估前近三天的病历中症状的记录和干预措施。
共纳入 168 名患儿。15 种症状中，12 种症状至少有 60%的患儿报告存在“非常困扰”，但这些症状在病历中记录的比例不到 60%。其中，最不常见记录的症状为思维或记忆问题（0%）、身体或面部外观改变（4.8%）、味觉改变（7.7%）以及手脚麻木或刺痛感（11.1%）。对于至少有 60%的患儿报告“非常困扰”的 10 种症状，干预措施的实施比例不到 60%。这些症状中，最不常见的治疗症状为思维或记忆问题（0%）、身体或面部外观改变（0%）、手脚麻木或刺痛感（0%）、味觉改变（0%）、腹泻（0%）和疲劳（1.6%）。
症状记录和干预措施的提供总体上较为少见。几乎从未记录或治疗的症状包括认知问题、身体形象问题、味觉改变和周围神经病变。未来的工作应将症状筛查纳入常规护理，并通过改善获取循证临床实践指南的途径，促进症状管理。
