Measuring physical symptoms in children and adolescents with cancer

The purpose of this review of the literature was to evaluate measures of physical symptoms in children and adolescents with cancer or those having completed treatment for cancer. Objectives included identification of instruments measuring physical symptoms, a description of how symptoms were conceptualized, description of reliability and validity measures, and assessment of developmental appropriateness for the intended age groups. The electronic databases Medline, Cumulative Index of Nursing and Allied Health Literature (CINAHL), and PsychLit were searched. Reports of cancer symptoms published in the English language between January 1988 and October 2003 were selected. Inclusion criteria were study samples consisting of children or adolescents with cancer and use of a tool developed for use in children or adolescents with cancer in which physical symptoms comprised a portion of the total measure. Nineteen studies met criteria for review and 23 instruments were identified. Five studies reported measures of the single symptoms of nausea and vomiting and fatigue; 9 studies reported measures of multiple symptoms. An additional 5 studies reported physical symptoms as a component of quality of life measures. Initial psychometric evaluation of these instruments demonstrates acceptable reliability and validity. Areas for future research include application of these measures in specific populations, intervention-based studies, and outcome-focused studies.