Measuring symptom occurrence and symptom distress: development of the symptom experience index

Authors

  • Mei R. Fu,

    1. Mei R. Fu BA BS MA MS PhD RN APRN-BC Assistant Professor College of Nursing, New York University, New York, USA
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  • Roxanne W. McDaniel,

    1. Roxanne W. McDaniel PhD RN Associate Professor, Associate Dean Sinclair School of Nursing, University of Missouri-Columbia, Columbia, Missouri, USA
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  • Verna A. Rhodes

    1. Verna A. Rhodes EdS RN FAAN Associate Professor Emeritus Sinclair School of Nursing, University of Missouri-Columbia, Columbia, Missouri, USA
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M.R. Fu: e-mail: mf67@nyu.edu

Abstract

Title. Measuring symptom occurrence and symptom distress: development of the symptom experience index

Aim.  This paper is a report of a study to assess reliability and construct validity of revised and refined version of the Adapted Symptom Distress Scale: the Symptom Experience Index (SEI).

Background.  The development of the SEI, a 41-item Likert Scale assessing 20 symptoms, was based on self-regulation theory and an integrative conceptual analysis of symptom assessment and management. The model emphasizes the difference between the occurrence of a symptom (or multiple symptoms) and the distress (emotional) response to the occurrence of a symptom. It is the distress from symptom occurrence that promotes a person to take action and use known coping strategies to prevent the symptom occurrence or alleviate the distress from the symptom.

Method.  A contrast-group and test-retest approach was used to assess construct validity and reliability with a convenience sample of 158 patients at United States of America in 2003–2004.

Results.  The SEI demonstrated reasonable internal consistency with a Cronbach's alpha of 0·91 for symptom experience, 0·85 for symptom occurrence and 0·84 for symptom distress. Test-retest reliability was supported by high intra-class correlation coefficients (symptom experience r = 0·93; symptom occurrence r = 0·94; symptom distress, r = 0·92). Construct validity was supported by statistically significant differences between patients and healthy adults.

Conclusion.  The SEI can be used as a baseline and outcome measure to assess the impact of multiple symptoms on patients, and the effectiveness of interventions to manage these symptoms.

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