Evaluation of the Utility of the Edmonton Symptom Assessment System (revised) Scale on a Tertiary Palliative Care Unit

The aim of this study was to evaluate the utility of the Edmonton Symptom Assessment System (ESAS-r) Scale on a tertiary palliative care unit.

There were 92 admitted patients who participated in the study; the scale was administered to those able to participate on day 1 (n = 35, 38 percent), on day 4 (n = 20, 21 percent), and weekly. Patient comfort level with the ESAS-r tool was assessed using a 5-point Likert scale (strongly disagree to strongly agree) on day 4. Nurses' and physicians' perceptions of clinical assessment pre- and postimplementation of the scale were surveyed using a 5-point Likert scale.

Of the participating physicians, 75 percent (n = 3) found that the ESAS-r Scale did not enhance clinical assessment; the proportion of nurses with that response was 37.5 percent (n = 6). Among these care providers, 50 percent of the physicians (n = 2) and 62 percent of the nurses (n = 10) thought that the scale was burdensome to patients; but 60 percent of the patients who were able to complete the comfort-level survey (n = 12) indicated that they did not find the scale burdensome.

Patient acuity, team expertise, perceived burden to patients, and time commitment all influenced staff's recommendation not to implement the ESAS-r tool on the palliative care unit.