Conference Proceedings - School of Nursing & Midwifery - Trinity ...

School of Nursing & Midwifery, Trinity College Dublin: 8 th Annual Interdisciplinary Research Conference
Transforming Healthcare Through Research, Education & Technology: 7 th – 9 th November 2007
Conference Proceedings
Hospital Anxiety and Depression Scale (HADS)
The HADS scale is a 14 item self assessment scale developed by
Zigmund and Snaith (1983) for detecting anxiety and depression in
a medical outpatient setting. As anxiety can contribute to the
symptoms of nausea and vomiting, it was important to identify
patients’ levels of anxiety using this tool. It is quick and easy to
complete and does not present a significant intrusion for patients
(Clark and Fallowfield 1986).
The HADS scale allows for careful differentiation of anxiety and
depression using two seven item subscales. Scores indicate the
severity of symptoms suggestive of anxiety and depression using a
scale of 0-21. Overall scores of 0-7 are considered a non-case, 8-10
borderline, and 11-21 a case. The HADS scale is able to avoid
somatic symptoms that could be attributed to physical disease
rather than anxiety or depression.
The Rotterdam Symptom Checklist (RSCL)
The Rotterdam Symptom Checklist (RSCL) was originally developed
as a tool to measure the symptoms reported by cancer patients
participating in clinical research trials in the Netherlands by de Haes
et al (1996). It comprises 30 items, each rated on a 4 point scale
measuring physical and psychological dimensions of quality of life.
It is easy to score and has been used in several cancer studies.
The RSCL is a self-report measure used to assess the quality of life
of cancer patients. It is designed to cover four domains, physical
symptom distress, psychological distress, activity level and overall
global life quality. These domains form the main scales. The items
regarding psychological distress have been interspersed among the
items regarding physical distress in order to avoid response sets in
the first place. It is easy to score and can be divided into different
subsets. There are two main subscales, one for physical symptoms
and the other for psychological issues. The scores given in the RSCL
are 1= (not at all), 2 = (a little), 3 = (quite a bit), 4 = (very much);
the highest score indicates the level of impairment (de Hanes
1996). The QOL item scores range from 1 = (excellent) at the top
to 7 = (very poor) at the bottom. Scale scores are obtained by
summating scores of individual items.
Daily Diary Cards
The UK Medical Research Council (MRC) Daily Diary Card (DCC) for
quality of life (QOL) assessment was first designed over twenty
years ago and since then has been used continuously in cancer
clinical trials organised by the MRC. However clinical trials using
DCCs have only reached maturity since 1989. According to Fayers
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