The measurement of symptoms in children with cancer

John J. Collins, Maura E. Byrnes, Ira J. Dunkel, Jeanne Lapin, Traci Nadel, Howard T. Thaler, Tanya Polyak, Bruce D. Rapkin, Russell K. Portenoy

Research output: Contribution to journalArticle

280 Citations (Scopus)

Abstract

The purpose of this study was to determine symptom prevalence, characteristics, and distress in children with cancer. The Memorial Symptom Assessment Scale (MSAS) 10-18, a 30-item patient-rated instrument adapted from a previously validated adult version, provided multidimensional information about the symptoms experienced by children with cancer. This instrument was administered to 160 children with cancer aged 10-18 (45 inpatients, 115 outpatients). To confirm the instrument's reliability and validity, additional data about symptoms were collected from both the parents and the medical charts, and retesting was performed on a subgroup of inpatients. Patients could easily complete the scale in a mean of 11 minutes. The analyses supported the reliability and validity of the MSAS 10-18 subscale scores as measures of physical, psychological, and global symptom distress, respectively. Symptom prevalence ranged from 49.7% for lack of energy to 6.3% for problems with urination. The mean (± SD) number of symptoms per inpatient was 12.7 ± 4.9 (range, 4-26), significantly more than the mean 6.5 ± 5.7 (range, 0-28) symptoms per outpatient. Patients who had recently received chemotherapy had significantly more symptoms than patients who had not received chemotherapy for more than 4 months (11.6 ± 6.0 vs. 5.2 ± 5.1), and those patients with solid tumors had significantly more symptoms than patients with either leukemia, lymphoma, or central nervous system malignancies (9.9 ± 7.0 vs. 6.8 ± 5.5 vs. 6.8 ± 5.0 vs. 8.0 ± 6.1). The most common symptoms (prevalence > 35%) were lack of energy, pain, drowsiness, nausea, cough, lack of appetite, and psychological symptoms (feeling sad, feeling nervous, worrying, feeling irritable). Of the symptoms with prevalence rates > 35%, those that caused high distress in more than one-third of patients were feeling sad, pain, nausea, lack of appetite, and feeling irritable. Subscale scores demonstrated large variability in symptom distress and could identify subgroups with high distress. The prevalence, characteristics, and distress associated with physical and psychological symptoms could be quantified in older children with cancer. The data confirm a high prevalence of symptoms overall and the existence of subgroups with high distress associated with one or multiple symptoms. Symptom distress is relatively higher among inpatients, children with solid tumors, and children who are undergoing antineoplastic treatment. Systematic symptom assessment may be useful in future epidemiological studies of symptoms and in clinical chemotherapeutic trials. Symptom epidemiology may also provide a focus for future clinical trials related to symptom management in children with cancer. (C) U.S. Cancer Pain Relief Committee, 2000.

Original languageEnglish (US)
Pages (from-to)363-377
Number of pages15
JournalJournal of Pain and Symptom Management
Volume19
Issue number5
DOIs
StatePublished - May 2000
Externally publishedYes

Fingerprint

Emotions
Symptom Assessment
Inpatients
Neoplasms
Appetite
Psychology
Reproducibility of Results
Nausea
Outpatients
Clinical Trials
Drug Therapy
Pain
Urination
Sleep Stages
Cough
Antineoplastic Agents
Epidemiologic Studies
Lymphoma
Leukemia
Epidemiology

Keywords

  • Cancer
  • Children
  • Malignancy
  • Pediatrics
  • Symptom distress
  • Symptoms

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Clinical Neurology
  • Neurology
  • Nursing(all)

Cite this

Collins, J. J., Byrnes, M. E., Dunkel, I. J., Lapin, J., Nadel, T., Thaler, H. T., ... Portenoy, R. K. (2000). The measurement of symptoms in children with cancer. Journal of Pain and Symptom Management, 19(5), 363-377. https://doi.org/10.1016/S0885-3924(00)00127-5

The measurement of symptoms in children with cancer. / Collins, John J.; Byrnes, Maura E.; Dunkel, Ira J.; Lapin, Jeanne; Nadel, Traci; Thaler, Howard T.; Polyak, Tanya; Rapkin, Bruce D.; Portenoy, Russell K.

In: Journal of Pain and Symptom Management, Vol. 19, No. 5, 05.2000, p. 363-377.

Research output: Contribution to journalArticle

Collins, JJ, Byrnes, ME, Dunkel, IJ, Lapin, J, Nadel, T, Thaler, HT, Polyak, T, Rapkin, BD & Portenoy, RK 2000, 'The measurement of symptoms in children with cancer', Journal of Pain and Symptom Management, vol. 19, no. 5, pp. 363-377. https://doi.org/10.1016/S0885-3924(00)00127-5
Collins JJ, Byrnes ME, Dunkel IJ, Lapin J, Nadel T, Thaler HT et al. The measurement of symptoms in children with cancer. Journal of Pain and Symptom Management. 2000 May;19(5):363-377. https://doi.org/10.1016/S0885-3924(00)00127-5
Collins, John J. ; Byrnes, Maura E. ; Dunkel, Ira J. ; Lapin, Jeanne ; Nadel, Traci ; Thaler, Howard T. ; Polyak, Tanya ; Rapkin, Bruce D. ; Portenoy, Russell K. / The measurement of symptoms in children with cancer. In: Journal of Pain and Symptom Management. 2000 ; Vol. 19, No. 5. pp. 363-377.
@article{717bb952fb584aa4b5e509af9ee8c583,
title = "The measurement of symptoms in children with cancer",
abstract = "The purpose of this study was to determine symptom prevalence, characteristics, and distress in children with cancer. The Memorial Symptom Assessment Scale (MSAS) 10-18, a 30-item patient-rated instrument adapted from a previously validated adult version, provided multidimensional information about the symptoms experienced by children with cancer. This instrument was administered to 160 children with cancer aged 10-18 (45 inpatients, 115 outpatients). To confirm the instrument's reliability and validity, additional data about symptoms were collected from both the parents and the medical charts, and retesting was performed on a subgroup of inpatients. Patients could easily complete the scale in a mean of 11 minutes. The analyses supported the reliability and validity of the MSAS 10-18 subscale scores as measures of physical, psychological, and global symptom distress, respectively. Symptom prevalence ranged from 49.7{\%} for lack of energy to 6.3{\%} for problems with urination. The mean (± SD) number of symptoms per inpatient was 12.7 ± 4.9 (range, 4-26), significantly more than the mean 6.5 ± 5.7 (range, 0-28) symptoms per outpatient. Patients who had recently received chemotherapy had significantly more symptoms than patients who had not received chemotherapy for more than 4 months (11.6 ± 6.0 vs. 5.2 ± 5.1), and those patients with solid tumors had significantly more symptoms than patients with either leukemia, lymphoma, or central nervous system malignancies (9.9 ± 7.0 vs. 6.8 ± 5.5 vs. 6.8 ± 5.0 vs. 8.0 ± 6.1). The most common symptoms (prevalence > 35{\%}) were lack of energy, pain, drowsiness, nausea, cough, lack of appetite, and psychological symptoms (feeling sad, feeling nervous, worrying, feeling irritable). Of the symptoms with prevalence rates > 35{\%}, those that caused high distress in more than one-third of patients were feeling sad, pain, nausea, lack of appetite, and feeling irritable. Subscale scores demonstrated large variability in symptom distress and could identify subgroups with high distress. The prevalence, characteristics, and distress associated with physical and psychological symptoms could be quantified in older children with cancer. The data confirm a high prevalence of symptoms overall and the existence of subgroups with high distress associated with one or multiple symptoms. Symptom distress is relatively higher among inpatients, children with solid tumors, and children who are undergoing antineoplastic treatment. Systematic symptom assessment may be useful in future epidemiological studies of symptoms and in clinical chemotherapeutic trials. Symptom epidemiology may also provide a focus for future clinical trials related to symptom management in children with cancer. (C) U.S. Cancer Pain Relief Committee, 2000.",
keywords = "Cancer, Children, Malignancy, Pediatrics, Symptom distress, Symptoms",
author = "Collins, {John J.} and Byrnes, {Maura E.} and Dunkel, {Ira J.} and Jeanne Lapin and Traci Nadel and Thaler, {Howard T.} and Tanya Polyak and Rapkin, {Bruce D.} and Portenoy, {Russell K.}",
year = "2000",
month = "5",
doi = "10.1016/S0885-3924(00)00127-5",
language = "English (US)",
volume = "19",
pages = "363--377",
journal = "Journal of Pain and Symptom Management",
issn = "0885-3924",
publisher = "Elsevier Inc.",
number = "5",

}

TY - JOUR

T1 - The measurement of symptoms in children with cancer

AU - Collins, John J.

AU - Byrnes, Maura E.

AU - Dunkel, Ira J.

AU - Lapin, Jeanne

AU - Nadel, Traci

AU - Thaler, Howard T.

AU - Polyak, Tanya

AU - Rapkin, Bruce D.

AU - Portenoy, Russell K.

PY - 2000/5

Y1 - 2000/5

N2 - The purpose of this study was to determine symptom prevalence, characteristics, and distress in children with cancer. The Memorial Symptom Assessment Scale (MSAS) 10-18, a 30-item patient-rated instrument adapted from a previously validated adult version, provided multidimensional information about the symptoms experienced by children with cancer. This instrument was administered to 160 children with cancer aged 10-18 (45 inpatients, 115 outpatients). To confirm the instrument's reliability and validity, additional data about symptoms were collected from both the parents and the medical charts, and retesting was performed on a subgroup of inpatients. Patients could easily complete the scale in a mean of 11 minutes. The analyses supported the reliability and validity of the MSAS 10-18 subscale scores as measures of physical, psychological, and global symptom distress, respectively. Symptom prevalence ranged from 49.7% for lack of energy to 6.3% for problems with urination. The mean (± SD) number of symptoms per inpatient was 12.7 ± 4.9 (range, 4-26), significantly more than the mean 6.5 ± 5.7 (range, 0-28) symptoms per outpatient. Patients who had recently received chemotherapy had significantly more symptoms than patients who had not received chemotherapy for more than 4 months (11.6 ± 6.0 vs. 5.2 ± 5.1), and those patients with solid tumors had significantly more symptoms than patients with either leukemia, lymphoma, or central nervous system malignancies (9.9 ± 7.0 vs. 6.8 ± 5.5 vs. 6.8 ± 5.0 vs. 8.0 ± 6.1). The most common symptoms (prevalence > 35%) were lack of energy, pain, drowsiness, nausea, cough, lack of appetite, and psychological symptoms (feeling sad, feeling nervous, worrying, feeling irritable). Of the symptoms with prevalence rates > 35%, those that caused high distress in more than one-third of patients were feeling sad, pain, nausea, lack of appetite, and feeling irritable. Subscale scores demonstrated large variability in symptom distress and could identify subgroups with high distress. The prevalence, characteristics, and distress associated with physical and psychological symptoms could be quantified in older children with cancer. The data confirm a high prevalence of symptoms overall and the existence of subgroups with high distress associated with one or multiple symptoms. Symptom distress is relatively higher among inpatients, children with solid tumors, and children who are undergoing antineoplastic treatment. Systematic symptom assessment may be useful in future epidemiological studies of symptoms and in clinical chemotherapeutic trials. Symptom epidemiology may also provide a focus for future clinical trials related to symptom management in children with cancer. (C) U.S. Cancer Pain Relief Committee, 2000.

AB - The purpose of this study was to determine symptom prevalence, characteristics, and distress in children with cancer. The Memorial Symptom Assessment Scale (MSAS) 10-18, a 30-item patient-rated instrument adapted from a previously validated adult version, provided multidimensional information about the symptoms experienced by children with cancer. This instrument was administered to 160 children with cancer aged 10-18 (45 inpatients, 115 outpatients). To confirm the instrument's reliability and validity, additional data about symptoms were collected from both the parents and the medical charts, and retesting was performed on a subgroup of inpatients. Patients could easily complete the scale in a mean of 11 minutes. The analyses supported the reliability and validity of the MSAS 10-18 subscale scores as measures of physical, psychological, and global symptom distress, respectively. Symptom prevalence ranged from 49.7% for lack of energy to 6.3% for problems with urination. The mean (± SD) number of symptoms per inpatient was 12.7 ± 4.9 (range, 4-26), significantly more than the mean 6.5 ± 5.7 (range, 0-28) symptoms per outpatient. Patients who had recently received chemotherapy had significantly more symptoms than patients who had not received chemotherapy for more than 4 months (11.6 ± 6.0 vs. 5.2 ± 5.1), and those patients with solid tumors had significantly more symptoms than patients with either leukemia, lymphoma, or central nervous system malignancies (9.9 ± 7.0 vs. 6.8 ± 5.5 vs. 6.8 ± 5.0 vs. 8.0 ± 6.1). The most common symptoms (prevalence > 35%) were lack of energy, pain, drowsiness, nausea, cough, lack of appetite, and psychological symptoms (feeling sad, feeling nervous, worrying, feeling irritable). Of the symptoms with prevalence rates > 35%, those that caused high distress in more than one-third of patients were feeling sad, pain, nausea, lack of appetite, and feeling irritable. Subscale scores demonstrated large variability in symptom distress and could identify subgroups with high distress. The prevalence, characteristics, and distress associated with physical and psychological symptoms could be quantified in older children with cancer. The data confirm a high prevalence of symptoms overall and the existence of subgroups with high distress associated with one or multiple symptoms. Symptom distress is relatively higher among inpatients, children with solid tumors, and children who are undergoing antineoplastic treatment. Systematic symptom assessment may be useful in future epidemiological studies of symptoms and in clinical chemotherapeutic trials. Symptom epidemiology may also provide a focus for future clinical trials related to symptom management in children with cancer. (C) U.S. Cancer Pain Relief Committee, 2000.

KW - Cancer

KW - Children

KW - Malignancy

KW - Pediatrics

KW - Symptom distress

KW - Symptoms

UR - http://www.scopus.com/inward/record.url?scp=0034081928&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034081928&partnerID=8YFLogxK

U2 - 10.1016/S0885-3924(00)00127-5

DO - 10.1016/S0885-3924(00)00127-5

M3 - Article

VL - 19

SP - 363

EP - 377

JO - Journal of Pain and Symptom Management

JF - Journal of Pain and Symptom Management

SN - 0885-3924

IS - 5

ER -