title: The Spanish version of the Edmonton Symptom Assessment System-revised (ESAS-r): first psychometric analysis involving patients with advanced cancer.
abstract: BACKGROUND
  The Edmonton Symptom Assessment System (ESAS) is a measure widely used in palliative care for the assessment of symptoms in patients with advanced cancer. The tool has been validated in different languages, including Spanish. A revised version (ESAS-r) was developed by Watanabe et al. in 2010.
  
  
  OBJECTIVE
  To develop the Spanish version of the ESAS-r and examine its psychometric properties.
  
  
  METHODS
  Based on the original English version, a group of experts created a Spanish version of the ESAS-r and administered it to a group of advanced cancer patients. Patients completed the ESAS and ESAS-r and were asked for their perceptions of the tool. The psychometric properties of the ESAS-r that were analyzed were equivalence, internal consistency, and discriminant validity.
  
  
  RESULTS
  Sixty-six patients from Spain and Guatemala participated in the survey. Patients perceived the ESAS-r to be significantly easier to understand and easier to complete than the ESAS. Significantly, patients preferred the ESAS-r (47%) to the ESAS (15%; P<0.0007). As to reliability, we found good internal consistency (Cronbach's alpha 0.86), and the equivalence of the two versions was between 0.71 and 0.94. The ESAS-r discriminates between inpatients and outpatients (Mann-Whitney U test; P=0.02) and among those with different palliative performance status (Spearman's rho for pain, tiredness, drowsiness, lack of appetite, well-being; P<0.01).
  
  
  CONCLUSIONS
  The ESAS-r is a valid instrument with adequate psychometric characteristics. This version is preferred by patients with advanced cancer. The Spanish version of the ESAS-r can, therefore, replace the use of the ESAS.
authors.affiliation: Faculty of Nursing, University of Navarra, Pamplona, Spain. acarvajal@unav.es
authors.forename: Ana
authors.initials: A
authors.lastname: Carvajal
authors.forename: Nezka
authors.initials: N
authors.lastname: Hribernik
authors.forename: Eva
authors.initials: E
authors.lastname: Duarte
authors.forename: Alvaro
authors.initials: A
authors.lastname: Sanz-Rubiales
authors.forename: Carlos
authors.initials: C
authors.lastname: Centeno
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis*; D010045:Outpatients; D010166:Palliative Care; D011594:Psychometrics; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D063189:Symptom Assessment; D014177:Translations