The proposed research, a response to RFA CA-05-013, REDUCING BARRIERS TO SYMPTOM MANAGEMENT AND PALLIATIVE CARE, will examine the validity, sensitivity, and patient usage of, and satisfaction with, a new electronic visual analogue scale (eVAS), used to quantify both physical (pain) and psychological (anxiety) symptoms in children and adolescents with cancer. We believe this patient-controlled user-friendly symptom assessment tool has the potential to standardize and improve symptom self-reporting; enable patients to report symptoms easily and frequently; heighten professional and family caregiver awareness of patient symptoms; and reduce patient, caregiver, and system barriers to the deliver/ of adequate symptom relief in cancer patients. The participants will be 20 patients aged 10-21 years receiving myeloablative therapy and stem cell transplantation, a treatment associated with severe physical pain and anxiety. Our primary aim is to test the concurrent validity of eVAS-pain and eVAS-anxiety by correlation with (1) standard paper visual analogue scales (pVAS-pain/pVAS-anxiety) and (2) other self-report paper instruments (BASES-R and STAIC). Secondary aims are to (3) test sensitivity to change of the eVAS in response to an intervention (IME) by comparing pre-IME and post-IME eVAS and pVAS asessments; (4) test the ability of eVAS to improve frequency of real-time symptom self-assessment versus current standard-olcare symptom assessments by nurses; (5) correlate eVAS usage with patient demographics; (6) examine correlation between eVAS-pain and eVAS-anxiety assessments in these patients; and (7) compare patient satisfaction with the eVAS to their satisfaction with paper symptom assessments. This research will provide important psychometric information about the validity of this innovative symptom assessment system, and its utility for inclusion in future multicenter clinical trials, particularly in patients with high-risk cancers undergoing intensive anti-cancer therapy associated with severe physical and psychological symptoms.
