title: Health care providers' use and knowledge of the Edmonton Symptom Assessment System (ESAS): is there a need to improve information and training?
abstract: OBJECTIVE
  The ESAS is a clinical symptom assessment tool developed for patients receiving palliative care for pain and symptom control. Recent studies have indicated that patients have difficulty understanding terminology and correct use of the ESAS, and that they appreciate the presence of a health care provider (HCP) to assist with ESAS completion. As appropriate assessment translates into effective treatment, it is important that HCPs have a good understanding of the tool. The purpose of this study was to assess HCPs' use, knowledge, and training needs of the ESAS.
  
  
  METHODS
  One hundred ninety-three HCPs in palliative care and chronic pain, who used the ESAS, were invited to participate in a survey.
  
  
  RESULTS
  The response rate was 43 % (n = 83), with 62 % nurses, 26 % physicians, and 12 % other specialties. Most participants were palliative care specialists (79 %). The majority (77 %) had a good understanding of the ESAS terms. Knowledge problems included distinguishing tiredness and drowsiness (25 %), interpreting shortness of breath as a combination of subjective and objective symptoms (19 %), not indicating current symptom level (14 %), and reverse scoring of well-being (13 %) and appetite (9 %). Reported challenges were misinterpretation of some ESAS terms, assessing patients with impaired communication, and lack of time and reliability of caregiver assessments. Participants offered suggestions regarding how their knowledge and use of the ESAS could be improved.
  
  
  CONCLUSIONS
  Suggestions for improving ESAS administration and training were to include term definitions and examples of how to ask about terms that might be challenging for patients. Furthermore, initial and ongoing training sessions might help to clarify issues with the tool.
authors.affiliation: Division of Palliative Care Medicine, University of Alberta, Edmonton, AB, Canada, daniela.buttenschoen@albertahealthservices.ca.
authors.forename: Daniela
authors.initials: D
authors.lastname: Carli Buttenschoen
authors.forename: Jarad
authors.initials: J
authors.lastname: Stephan
authors.forename: Sharon
authors.initials: S
authors.lastname: Watanabe
authors.forename: Cheryl
authors.initials: C
authors.lastname: Nekolaichuk
mesh_terms: D000328:Adult; D017028:Caregivers / Q000193:education / Q000592:standards; D059350:Chronic Pain / Q000175:diagnosis* / Q000628:therapy; D003430:Cross-Sectional Studies; D005260:Female; D006282:Health Personnel / Q000193:education / Q000592:standards; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000175:diagnosis* / Q000628:therapy; D010147:Pain Measurement / Q000379:methods* / Q000592:standards; D010166:Palliative Care / Q000379:methods*; D015203:Reproducibility of Results; D063189:Symptom Assessment / Q000379:methods*
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