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The Clinical Guide to Supportive and Palliative Care for HIV/AIDS

The Clinical Guide to Supportive and Palliative Care for HIV/AIDS

The Clinical Guide to Supportive and Palliative Care for HIV/AIDS

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A <strong>Clinical</strong> <strong>Guide</strong> <strong>to</strong> <strong>Supportive</strong> <strong>and</strong> <strong>Palliative</strong> <strong>Care</strong> <strong>for</strong> <strong>HIV</strong>/<strong>AIDS</strong> • Chapter 3: Assessment of Physical Symp<strong>to</strong>msFigure 3-7: Edmon<strong>to</strong>n Symp<strong>to</strong>m Assessment Scale (ESAS) (continued)Edmon<strong>to</strong>n Symp<strong>to</strong>m Assessment: Visual Analogue Scale26 picasName: ____________________________________________Room#: ____________________________________________Please cross the line at the point that best describes: (For coding)WorstNo Pain ________________________________________________________________________ PossiblePainWorstNot Tired ________________________________________________________________________ PossibleTirednessWorstNot Nauseated ________________________________________________________________________ PossibleNauseaWorstNot Depressed ________________________________________________________________________ PossibleDepressionWorstNot Anxious ________________________________________________________________________ PossibleAnxietyWorstNot Drowsy ________________________________________________________________________ PossibleDrowsinessWorstBest Appetite ________________________________________________________________________ PossibleAppetiteBest FeelingWors<strong>to</strong>f Well Being ________________________________________________________________________ Feeling ofWell BeingNo ShortnessWors<strong>to</strong>f Breath ________________________________________________________________________ Shortnessof BreathWorstOther Problems ________________________________________________________________________ PossiblePainAssessed by:______________________________________Source: Bruera E, Kuehn N, Miller MJ, Macmillan K. <strong>The</strong> Edmon<strong>to</strong>n Symp<strong>to</strong>m Assessment Scale: a simple method <strong>for</strong> the assessmen<strong>to</strong>f palliative care patients. J Palliat <strong>Care</strong> 7:6-9, 1991. Reproduced with permission. Copyright 1991.78U.S. Department of Health <strong>and</strong> Human Services • Health Resources <strong>and</strong> Services Administration • <strong>HIV</strong>/<strong>AIDS</strong> Bureau

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