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FACET - European Journal of Cancer Care December 2003 Developing a chemotherapy symptom assessment scale Dikken C.

1 Brown V.

1 Sitzia J.

1 Richardson A.

2 Hughes J.

1 Hannon H.

3 & Oakley C.

3

Why is it important to assess symptoms patients experience during chemotherapy?

Structured symptom assessment is important to the good management of side-effects during chemotherapy treatment.

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FACET - European Journal of Cancer Care December 2003 Developing a chemotherapy symptom assessment scale (continued)

Existing assessment scales include:

• ‘Home-produced’ checklists • Toxicity rating scales • Research scales

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FACET - European Journal of Cancer Care December 2003 Developing a chemotherapy symptom assessment scale (continued)

The Chemotherapy Symptom Assessment Scale (C-SAS)

• What is it?

• How was it developed?

• Where was it developed?

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FACET - European Journal of Cancer Care December 2003 Developing a chemotherapy symptom assessment scale (continued)

Development of the C-SAS (1)

• Data collection for the initial descriptive study through a self report assessment scale (WCQ75) • Positive feedback from patients using the WCQ75 • Further refinement of the scale leads to the C-SAS

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FACET - European Journal of Cancer Care December 2003 Developing a chemotherapy symptom assessment scale (continued)

What is the C-SAS?

• A self-assessment scale to measure side-effects of chemotherapy treatment • 24 questions • Administered following each chemotherapy episode

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FACET - European Journal of Cancer Care December 2003 Developing a chemotherapy symptom assessment scale (continued)

Development of the C-SAS (2)

• Exploration of WCQ item pool.

• Literature review • Pilot study

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FACET - European Journal of Cancer Care December 2003 Developing a chemotherapy symptom assessment scale (continued)

Development of the C-SAS (3)

• Patient involvement

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FACET - European Journal of Cancer Care December 2003 Developing a chemotherapy symptom assessment scale (continued)

Development of the C-SAS (4)

• Health professional involvement • Item consensus generation

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FACET - European Journal of Cancer Care December 2003 Developing a chemotherapy symptom assessment scale (continued)

Validity and reliability of the C-SAS

Validity:

• Content • • Criterion Construct

Reliability:

• Test-retest reliability • Internal consistency

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FACET - European Journal of Cancer Care December 2003 Developing a chemotherapy symptom assessment scale (continued)

Why is the C-SAS innovative? (1)

• Specifically designed for the purpose • Rigorous development • Patients and health professionals were involved in its development

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FACET - European Journal of Cancer Care December 2003 Developing a chemotherapy symptom assessment scale (continued)

Why is the C-SAS innovative? (2)

• Empowers • Improves knowledge • Improves communication • Individualised patient management

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FACET - European Journal of Cancer Care December 2003 Developing a chemotherapy symptom assessment scale (continued)

Introducing the C-SAS into clinical practice

• Lack of funding for formal evaluation of the C-SAS • Teething problems on introduction

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FACET - European Journal of Cancer Care December 2003 Developing a chemotherapy symptom assessment scale (continued)

Introducing the C-SAS into clinical practice

• Management of change • Time factor associated with use

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FACET - European Journal of Cancer Care December 2003 Developing a chemotherapy symptom assessment scale (continued)

• • • •

Further reading

Brown V, Sitzia J, Richardson A, Hughes J, Hannon H, Oakley C. (2001) The development of the Chemotherapy Symptom Assessment Scale (C-SAS©): a scale for the routine clinical assessment of the symptom experiences of patients receiving cytotoxic chemotherapy. International Journal of Nursing Studies 38(5): 497- 510.

Buckingham R, Fitt J, Sitzia J. (1997) Patients' experiences of chemotherapy: side-effects of carboplatin in the treatment of carcinoma f the ovary. European Journal of Cancer Care. 6: 59- 71.

Dennison, S. (1995) An exploration of the communication that takes place between nurses and patients whilst cancer chemotherapy is being administered. Journal of Clinical Nursing 4: 227-233.

Dikken C, Sitzia J. (1998) Patients' experiences of chemotherapy: side-effects associated with 5 fluorouracil + folinic acid in the treatment of colorectal cancer. Journal of Clinical Nursing. 7: 371 379.

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FACET - European Journal of Cancer Care December 2003 Developing a chemotherapy symptom assessment scale (continued)

• • • • •

Further reading

(continued)

Given, B. (1991) Compliance and health promotion behaviours. In: Baird, S.B., McCorkle, R., Grant, M. (Eds.), Cancer Nursing: A Comprehensive Textbook. Philadelphia, W.B. Saunders, pp 61-73.

Holmes, S., Eburn, E. (1989) Patients’ and nurses’ perceptions of symptom distress in cancer. Journal of Advanced Nursing 14: 840-846.

Richardson, A. (1995) Fatigue in cancer patients: a review of the literature. European Journal of Cancer Care 4: 20-32.

Richardson, J.L., Marks, G., Levine, A. (1988) The influence of symptoms of disease and side-effects of treatment on compliance with cancer therapy. Journal of Clinical Oncology 6: 1746-1751.

Sitzia J, Hughes J, Sobrido L. (1995) A study of patients' experiences of side-effects associated with chemotherapy: pilot stage report. International Journal of Nursing Studies. 32(6): 580- 600.

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FACET - European Journal of Cancer Care December 2003 Developing a chemotherapy symptom assessment scale (continued)

• • • • •

Further reading

(continued)

Sitzia J, Dikken C, Hughes J. (1997) Psychometric evaluation of a questionnaire to document side effects of chemotherapy Journal of Advanced Nursing. 25: 999- 1007.

Sitzia J, Dikken C. (1997) Survey of the incidence and severity of side effects reported by patients receiving six cycles of FEC chemotherapy. Journal of Cancer Nursing. 1: 61- 73.

Sitzia J, North C, Stanley J, Winterberg N. (1997) Side effects of CHOP in the treatment of non-Hodgkin's lymphoma Cancer Nursing. 20(6): 430- 439.

Sitzia J, Huggins L. (1998) Side effects of combination cyclophosphamide, methotrexate and 5-fluorouracil (CMF) chemotherapy for breast cancer. Cancer Practice. 6(1): 13- 21.

Tanghe A, Evers G, Paridaens R. (1998) Nurses’ assessment of symptom occurrence and symptom distress in chemotherapy patients. European Journal of Oncology Nursing (2):14-26

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