| Mohamed Alorabi,Dina Salem,Azza Adel,Ahmed Ezzat,Zeinab Elsayed. Feasibility and reliability of the revised Edmonton Symptom Assessment System (ESAS-r) in Egyptian patients with advanced cancer: A single institutional experience. Oncol Transl Med, 2016, 2: 132-137. |
| Feasibility and reliability of the revised Edmonton Symptom Assessment System (ESAS-r) in Egyptian patients with advanced cancer: A single institutional experience |
| Received:January 23, 2016 Revised:May 27, 2016 |
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| KeyWord:advanced cancer; palliative care; Egypt; Edmonton Symptom Assessment System (ESAS) |
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| Abstract: |
| Objective This study aims to test the acceptance, feasibility, and usefulness of the Arabic version of the
revised Edmonton Symptom Assessment System (ESAS-r) among Egyptian patients with advanced cancer
and to compare the rates of symptoms documented by patients and physicians.
Methods Between August 2014 and February 2015, a total of 140 patients at Ain Shams University
Hospitals in Cairo, Egypt received the Arabic version of the ESAS-r. For each patient, the ESAS-r was
completed twice, first by the treating physician (as part of the basic assessment) and a second time by the
patient, with a maximum of 2 hours between the two assessments. An additional survey was included to
assess patients’ acceptance of the survey and their preferences.
Results Out of 140 enrolled patients in the study, 11 patients refused to complete the questionnaire, and
10 patients were excluded due to incomplete records in their medical records. Complete data was retrieved
for 119 patients who were included for further analyses. The 78 (65%) patients declared that the test was
clear and easy to complete. They were able to answer the test without help. Collectively, tiredness and
sense of well-being were the most commonly encountered symptoms in ratings obtained by both patients
and physicians. Tiredness was the only symptom showing a significant difference between the two rating
methods, patient-rated scores being higher (P = 0.032). Cronbach’s alpha showed that both tests completed by the physician and the patients were internally consistent: the physician-rated test had a coefficient
of 0.877, and the patient-rated test had a coefficient of 0.863. All ESAS scores had good internal consistency, with a Cronbach’s alpha coefficient of 0.88. The internal consistency remained high after removal of
individual symptom scores, with Cronbach’s alpha coefficients ranging from 0.823 to 0.902, indicating that
no individual question had undue influence on the total ESAS score.
Conclusion The ESAS-r was easily understood by and applicable to patients. There was no significant
discrepancy in the rates of symptoms reported by the patients and physicians, apart from tiredness. Based
on this, the test could be applied on a larger scale with in-home patients. This test can be cost-effective and
can decrease the number of hospital visits among advanced cancer patients in need of supportive treatment rather than active cancer therapy |
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