title: Testing the feasibility of using the Edmonton Symptom Assessment System (ESAS) to assess caregiver symptom burden.
abstract: OBJECTIVE
  Caregiver symptom assessment is not part of regular clinical cancer care. The ESAS (Edmonton Symptom Assessment System) is a multidimensional tool regularly used to measure symptom burden in patients but not caregivers. The objectives of the present study were to determine the feasibility of the ESAS in caregiver completion (defined as ≥ 9 of 12 items) and determine its concurrent validity with the Zarit Burden Interview-12 (ZBI-12).
  
  
  METHODS
  We conducted a prospective study on 90 patient-primary caregiver dyads seen in an outpatient supportive care center in a cancer center. The 12 item ESAS-FS (financial-spiritual) was completed by the dyads along with other clinical and psychosocial measures.
  
  
  RESULTS
  The caregiver ESAS was found to be feasible (90/90 caregivers, 100% completed ≥ 9/12 items) and useful (66/90 caregivers, 73%) by caregivers to report their symptom burden. Some 68 of 90 (76%) caregivers had symptom distress scores ≥ 4 on at least one symptom. A significant association was found between the ESAS scores of caregivers and patients for fatigue (0.03), depression (<0.01), anxiety (<0.01), sleep (0.05), well-being (<0.01), financial distress (<0.01), spiritual pain (<0.01), and total ESAS score (<0.01). Concurrent validity with the ZBI-12 was not achieved (r = 0.53, p = 0.74). A significant correlation was found between caregiver ESAS scores and time spent feeding, housekeeping, total combined caregiver activities, and total ZBI-12 scores.
  
  
  CONCLUSIONS
  The caregiver ESAS is a feasible tool and was found useful by our caregivers. Further research is needed to modify the ESAS based on caregivers' recommendations, and further psychometric studies need to be conducted.
authors.affiliation: Department of Palliative, Rehabilitation, and Integrative Medicine,The University of Texas MD Anderson Cancer Center,Houston,Texas.
authors.forename: Kimberson
authors.initials: K
authors.lastname: Tanco
authors.affiliation: Department of Palliative, Rehabilitation, and Integrative Medicine,The University of Texas MD Anderson Cancer Center,Houston,Texas.
authors.forename: Marieberta
authors.initials: M
authors.lastname: Vidal
authors.affiliation: Department of Palliative, Rehabilitation, and Integrative Medicine,The University of Texas MD Anderson Cancer Center,Houston,Texas.
authors.forename: Joseph
authors.initials: J
authors.lastname: Arthur
authors.affiliation: Department of Palliative, Rehabilitation, and Integrative Medicine,The University of Texas MD Anderson Cancer Center,Houston,Texas.
authors.forename: Marvin
authors.initials: M
authors.lastname: Delgado Guay
authors.affiliation: Department of Palliative, Rehabilitation, and Integrative Medicine,The University of Texas MD Anderson Cancer Center,Houston,Texas.
authors.forename: David
authors.initials: D
authors.lastname: Hui
authors.affiliation: Department of Biostatistics,The University of Texas MD Anderson Cancer Center,Houston,Texas.
authors.forename: Diane
authors.initials: D
authors.lastname: Liu
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine,The University of Texas MD Anderson Cancer Center,Houston,Texas.
authors.forename: Gary
authors.initials: G
authors.lastname: Chisholm
authors.affiliation: Department of Palliative, Rehabilitation, and Integrative Medicine,The University of Texas MD Anderson Cancer Center,Houston,Texas.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bruera
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000523:psychology; D011446:Prospective Studies; D011594:Psychometrics / Q000295:instrumentation / Q000379:methods; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D063189:Symptom Assessment / Q000379:methods* / Q000592:standards; D013781:Texas
keywords: Caregiver ESAS; Caregiver symptom assessment; Caregiver symptom burden