The Edmonton Symptom Assessment System - Revised (ESAS-r)
The ESAS is a tool that was developed to assist in the assessment of nine symptoms that are common in palliative care patients: pain, tiredness, drowsiness, nausea, lack of appetite, depression, anxiety, shortness of breath, and wellbeing. The ESAS has been revised to improve ease of understanding and completion for patients and is known as the ESAS-r. The ESAS-r is intended to capture the patient’s perspective on symptoms. However, in some situations it may be necessary to obtain a caregiver’s perspective. The ESAS-r provides a profile of symptom severity at a point in time. Repeated assessments may help to track changes in symptom severity over time. The ESAS-r is only one part of a holistic clinical assessment. It is not a complete symptom assessment in itself.
Watanabe SM, Nekolaichuk C, Beaumont C, Johnson L, Myers J, Strasser F. A multi-centre comparison of two numerical versions of the Edmonton Symptom Assessment System in palliative care patients J Pain Symptom Manage 2011; 41:456-468.
Bruera E, Kuehn N, Miller MJ, Selmser P, Macmillan K. The Edmonton Symptom Assessment System (ESAS): a simple method for the assessment of palliative care patients. J Palliat Care 1991; 7:6-9.
Fraser Health Symptom Assessment Acronym (OPQRSTUV Evaluations)
The Symptom Assessment Acronym is a tool to aid in a detailed systematic approach to assess palliative or end of life symptoms. This tool guided a consistent and comprehensive symptom assessment in palliative or end of life care.
Algorithms used for specific symptom managements available at
Muir J. (2006). Unrelieved Pain. Nursing BC. October; 38(4):22-5.
Peden J, deMoissac D, MacMillan K, Mushani-Kanji T, editors (2006). 99 Common Questions (and more) about hospice palliative care A nurse’s handbook. 3rd ed. Part I Physical Symptoms. Edmonton, Alberta: Regional Palliative Care Program, Capital Health; p. 2-96.