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Original research
Symptom documentation and intervention in paediatric cancer care-association with severity: observational study
  1. Deborah Tomlinson1,
  2. Lauren Chakkalackal1,
  3. Maryann Calligan1,
  4. Cassandra Tardif-Theriault1,
  5. Susan Kuczynski2,
  6. Tal Schechter3,
  7. Emily Vettese1,
  8. George A Tomlinson4,
  9. L Lee Dupuis1,5,6 and
  10. Lillian Sung1,3
  1. 1 Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
  2. 2 Ontario Parents Advocating for Children with Cancer, Pediatric Oncology Group of Ontario, Toronto, Ontario, Canada
  3. 3 Division of Hematology and Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
  4. 4 Department of Medicine, Toronto General Hospital, Toronto, Ontario, Canada
  5. 5 Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
  6. 6 Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Dr Lillian Sung, Peter Gilgan Centre for Research and Learning, Toronto, ON M5G 0A4, Canada; lillian.sung{at}sickkids.ca

Abstract

Objectives Primary objectives were to determine the relationship between prevalence of symptom documentation and intervention provision, and increasing severity of bothersome symptoms, as identified by guardians using guardian-reported Symptom Screening in Pediatrics Tool (proxy-SSPedi), which is validated and measures the extent of bothersome symptoms in paediatric patients with cancer.

Methods We included guardians of children 2–7 years of age receiving cancer treatments and seen in hospital daily for 4 consecutive days. Guardians reported proxy-SSPedi at study enrolment and 3 days later. Chart review was performed between the day prior and the day following proxy-SSPedi completion. Symptom documentation and intervention provision were determined by two independent abstractors.

Results We enrolled 190 guardians who provided 371 proxy-SSPedi assessments in 190 children. The most common severely bothersome symptoms were ‘feeling tired’, ‘feeling more or less hungry than they usually do’ and ‘feeling cranky or angry’. Among those with increasing severity of bother, documentation was significantly more common for 12 symptoms while intervention was significantly more common for 7 symptoms. Intervention was not significantly more common with increasing severity of bother due to ‘feeling tired’, ‘feeling more or less hungry than they usually do’ and ‘feeling cranky or angry’.

Conclusions Symptom documentation was generally more common in patients with severely bothersome symptoms. Intervention was not more common among those with increasing severity of bother due to fatigue, changes in hunger or anger, which were the most common severely bothersome symptoms. Future efforts should focus on facilitating intervention provision to patients with bothersome symptoms.

  • Paediatrics
  • Symptoms and symptom management
  • Psychological care
  • Quality of life
  • Communication

Data availability statement

Data are available upon reasonable request. Data are available upon reasonable request from the corresponding author.

https://doi.org/10.1136/spcare-2022-003874

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    Data availability statement

    Data are available upon reasonable request. Data are available upon reasonable request from the corresponding author.

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    Footnotes

    • Contributors DT—conceptualisation, methodology, writing (original draft), reviewing, editing. LC—methodology, writing (reviewing), editing. MC—methodology, writing (reviewing), editing. CT-T—methodology, writing (reviewing), editing. SK—conceptualisation, writing (reviewing), editing. TS—conceptualisation, methodology, writing (reviewing), editing. EV—project administration, methodology, writing (reviewing), editing. GAT— formal analysis, writing (reviewing), editing. LLD—conceptualisation, methodology, writing (reviewing), editing. LS— guarantor, conceptualisation, methodology, supervision, writing (original draft), reviewing, editing.

    • Funding This work was supported by a grant from the Pediatric Oncology Group Ontario (POGO). LS is supported by the Canada Research Chair in paediatric oncology supportive care.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.