Author Affiliations: Queensland University of Technology (QUT), Centre for Healthcare Transformation and School of Nursing at Centre of Children's Health Research (Drs Bradford, Bowers, Chan, and Yates and Herbert); Queensland Children's Hospital (Drs Walker and Herbert and Mss Cashion and Condon); Princess Alexandra Hospital (Dr Chan); and The University of Queensland, School of Medicine (Drs Herbert and Walker), Brisbane, Queensland, Australia.
Cancer Nurs. 2021;44(6):443-452. doi: 10.1097/NCC.0000000000000849.
Symptom management is a cornerstone of quality care and has the potential to vastly influence patient experiences. The supportive care needs of children, however, are not well described.
The aims of this study were to describe documentation about assessment and occurrence of symptoms in medical records of children with cancer and to compare the profile of documented symptoms with child self-report.
Twelve weeks of medical records of children (8-18 years) newly diagnosed with cancer were reviewed, and data were extracted regarding symptom assessment and occurrence. A second cohort of children attending oncology outpatients completed the electronic Symptom Screening in Pediatrics self-report of symptom bother. They also answered additional questions about other symptoms and the experience of self-report. We evaluated the profile of symptoms recorded as assessed by healthcare providers and self-reported by children.
One thousand three hundred sixteen symptoms were identified in 3642 assessments. The symptoms most commonly documented by medical and nursing staff were nausea, pain, and appetite. Allied health staff most frequently documented fatigue, feeling scared, or sad. Forty-eight children completed self-report for the same symptoms and identified fatigue, appetite, and taste were the most bothersome. Children were positive about the experience of completing self-report.
This study adds further to the evidence about the importance of obtaining information beyond routine clinical assessment from children themselves.
Healthcare providers do not routinely identify all distressing symptoms during clinical encounters. Use of patient-reported outcome measures in children is feasible and acceptable and empowers children to communicate about symptoms, which can facilitate prompt intervention.
症状管理是优质护理的基石，有可能极大地影响患者的体验。然而，儿童的支持性护理需求并未得到很好的描述。
本研究旨在描述癌症儿童病历中症状评估和发生情况的记录，并将记录的症状与儿童自我报告的症状进行比较。
对新诊断为癌症的 8-18 岁儿童的医疗记录进行了 12 周的回顾，提取了有关症状评估和发生的资料。第二组在肿瘤门诊就诊的儿童完成了电子儿科症状筛查自我报告的症状困扰。他们还回答了其他关于症状和自我报告体验的问题。我们评估了医疗保健提供者记录的和儿童自我报告的症状特征。
在 3642 次评估中发现了 1316 种症状。医护人员记录最多的症状是恶心、疼痛和食欲。辅助卫生人员最常记录的是疲劳、恐惧或悲伤。48 名儿童完成了相同症状的自我报告，发现疲劳、食欲和味觉最令人困扰。儿童对完成自我报告的体验持积极态度。
本研究进一步证明了从儿童自身获取常规临床评估之外的信息的重要性。
医疗保健提供者在临床接触中并没有常规识别所有令人不适的症状。在儿童中使用患者报告的结果测量是可行且可接受的，并使儿童能够交流症状，这有助于及时干预。
