Divergent Perspectives on the Use of the Edmonton Symptom Assessment System (Revised) in Palliative Care. Issue 1 (February 2020)

• Record Type: Journal Article
• Authors: Schick-Makaroff, Kara; Sawatzky, Richard
• Is Part Of: Journal of hospice and palliative nursing. Volume 22:Issue 1(2020)
• Publication Date: 2020-02
• Subjects: Edmonton Symptom Assessment System (Revised) -- knowledge-to-action -- palliative home care -- qualitative research -- tertiary palliative care; Hospice care -- Periodicals; Palliative treatment -- Periodicals; Terminal care -- Periodicals; Nursing -- Philosophy -- Periodicals; Nursing -- Research -- United States -- Periodicals; Hospice nurses -- Training of -- United States -- Periodicals; 616.029
• DOI: 10.1097/NJH.0000000000000617
• Languages: English
• ISSNs: 1522-2179

Abstract

Abstract : The Edmonton Symptom Assessment System (Revised) (ESAS-r) contains 9 questions pertaining to symptoms/well-being. It is a standardized patient-reported assessment instrument, but inconsistently used in palliative care. Thus, a problem exists in knowledge translation regarding routine use of the ESAS-r in palliative practice. The objective was to understand clinicians' perspectives on the use of the ESAS-r in palliative care in hospitals and at home. Qualitative focus groups (n = 14 with 46 clinicians) and interviews (n = 24) elicited views regarding use of the ESAS-r in palliative practice. Interpretive description was used as a general approach to this qualitative analysis focused on understanding clinicians' views. Palliative clinicians presented multiple perspectives of the ESAS-r pertaining to their (1) underlying values, (2) disparate purposes, and (3) incommensurate responses toward use in daily practice. Benefits and challenges supported diversity within these themes, highlighting divergence among perspectives and complexity of integrating a standardized tool in patient care. Integration of the ESAS-r in palliative care requires (1) educational support for developing competence; (2) consideration of clinicians' existing, heterogeneous beliefs regarding the use of standardized assessment instruments; and (3) Consultation with multidisciplinary practitioners about optimal ways that ESAS-r results can be used in a person-centered approach to palliative care. Abstract : Supplemental digital content is available in the text.