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Symptom documentation and intervention provision for symptom control in children receiving cancer treatments
Shannon Hyslop1, Hailey Davis1, Nathan Duong1
1Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 686 Bay Street, Toronto, Ontario, M5G 0A4, Canada.
Insights
Pediatric cancer patients frequently reported bothersome symptoms, but documentation and interventions were infrequent. Key symptoms like cognitive changes and body image issues were rarely addressed, highlighting a need for improved care integration.
Area of Science:
- Pediatric Oncology
- Clinical Informatics
- Symptom Management
Background:
- Pediatric cancer patients experience numerous bothersome symptoms.
- Effective symptom management is crucial for improving quality of life in young cancer patients.
Purpose of the Study:
- To determine the rate of symptom documentation in medical records using the Symptom Screening in Pediatrics Tool (SSPedi).
- To assess the frequency of interventions for self-reported bothersome symptoms in pediatric cancer patients.
Main Methods:
- Inclusion of 168 pediatric inpatients (aged 8-18) undergoing cancer treatment.
- Self-reporting of symptom bother using the SSPedi.
- Evaluation of medical record documentation and interventions proximal to SSPedi administration.
Main Results:
- Less than 60% of 15 bothersome symptoms were documented for 12 symptoms.
- Cognitive issues, body image changes, taste alterations, and neuropathy were infrequently documented.
- Interventions for highly bothersome symptoms occurred less than 60% of the time for 10 symptoms, with several symptoms receiving no intervention.
Conclusions:
- Symptom documentation and intervention provision were generally infrequent in pediatric cancer care.
- Cognitive, body image, taste, and neuropathy symptoms were notably under-documented and untreated.
- Integrating symptom screening into routine care and enhancing access to clinical guidelines are recommended.
Background:
Objectives were to describe the proportion of bothersome symptoms self-reported using the Symptom Screening in Pediatrics Tool (SSPedi) documented in the medical records and associated with an intervention.
Methods:
Eligible respondents were inpatients aged 8-18 years receiving cancer treatments and expected to be in hospital or clinic three days later. Children self-reported symptom bother using SSPedi. We evaluated symptom documentation and interventions in the medical records proximal to SSPedi administration.
Results:
There were 168 children included. Symptoms rated as at least 'a lot' bother were documented in the medical record less than 60% of the time for 12 of 15 symptoms. Of these symptoms, the most infrequently documented symptoms were problems with thinking or remembering things (0%), changes in how your body or face look (4.8%), changes in taste (7.7%) and tingly or numb hands or feet (11.1%). Intervention provision for symptoms rated as 'a lot' bother occurred less than 60% of the time for 10 of 15 symptoms. Of these symptoms, the most infrequently treated were thinking or remembering things (0%), changes in how your body or face look (0%), tingly or numb hands or feet (0%), changes in taste (0%), diarrhoea (0%) and feeling tired (1.6%).
Conclusions:
Documentation of symptoms and intervention provision were generally infrequent. Symptoms that were almost never documented or treated included problems with cognition, body image, taste changes and peripheral neuropathy. Future efforts should incorporate symptom screening into routine care and facilitate symptom management by improving access to evidence-based clinical practice guidelines.
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