title: High scores on the Edmonton Symptom Assessment Scale identify patients with self-defined high symptom burden.
abstract: The terms symptom burden and symptom distress are frequently seen in palliative care literature yet are used in multiple ways ranging from addition of symptom scores to more in-depth assessments of interference in function. Patient input to date has had little role in these varied definitions yet previous reviews have suggested the importance of such input. This mixed qualitative and quantitative prospective study was conducted to seek patient input into the definition of 'symptom burden' and to correlate burden self-ranked scores with symptom scores on the Edmonton Symptom Assessment Scale (ESAS). Results suggest that patients with advanced disease followed by palliative care providers are a group with a high level of self-defined burden. Further, any patient rating one or more symptoms on the ESAS ≥7 is at high risk of self-defined burden and likely to be experiencing significant impact on physical, emotional and social functioning. Further work should look at which aspects of symptom management best promote a lessening of perceived burden.
authors.affiliation: Palliative Care Department, Sunnybrook Health Sciences Center, University of Toronto, Canada. debbie.selby@sunnybrook.ca
authors.forename: Debbie
authors.initials: D
authors.lastname: Selby
authors.forename: Anita
authors.initials: A
authors.lastname: Chakraborty
authors.forename: Jeff
authors.initials: J
authors.lastname: Myers
authors.forename: Refik
authors.initials: R
authors.lastname: Saskin
authors.forename: Paolo
authors.initials: P
authors.lastname: Mazzotta
authors.forename: Ashlinder
authors.initials: A
authors.lastname: Gill
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002173:Cancer Care Facilities; D003863:Depression; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000473:pathology / Q000523:psychology*; D009864:Ontario; D010146:Pain; D010166:Palliative Care / Q000523:psychology* / Q000706:statistics & numerical data; D011446:Prospective Studies; D011788:Quality of Life; D018434:Sickness Impact Profile; D013315:Stress, Psychological