Patients with advanced cancer and their families frequently present to the nurse many medical, psychological and social problems. Although these problems are well recognized, rarely are they evaluated independently in a systematic way. Structured assessment tools which detect and quantify these problems, become a permanent part of the patient's record, and provide a means to follow patient function during the course of treatment, are seldom used. Reasons given by nurses for this ommission are lack of time, assessment tools of excessive length, and the need to use a separate tool to assess each area of patient function. There is, therefore, a compelling need for a validated and concise assessment tool for nurses working with cancer patients. Such a tool, called the Comprehensive Patient Evaluation Scale (CPES), has been developed by the principal investigator and collaborators to assess individually and in combination the degree of impairment in five separate dimensions important to the well-being of cancer patients. These dimensions - physical, psychological, social, discomfort, and pain - are the subscales of the CPES. The power of this tool lies in its ability to document and quantify patterns of patient deterioration and progress, the results of which can be used for both predictive and preventive purposes. This study will validate the CPES, evaluate its usefulness for nurses, physicians and social workers working with cancer patients, and determine whether training enhances the degree of agreement among raters from these three disciplines.
These aims will be accomplished by having eight oncology nurses watch 36 patient interviews and rate each patient using prevalidated assessment tools and the CPES, and by having 20 nurses, 20 physicians and 20 social workers watch 6 of the original 36 videotaped patient interviews and rate the patients on 3 subscales of the CPES. One - half of the raters in each discipline will be trained to use the CPES.
