The symptom experiences of Puerto Rican children undergoing cancer treatments and alleviation practices as reported by their mothers.

Although symptoms during cancer treatments are prevalent and are important clinical outcomes of childhood cancer, the symptom experiences of Puerto Rican children along with the symptom alleviation/care practices that parents provide during cancer treatments have received limited attention. To examine the occurrence/severity of symptoms on the Therapy-Related Symptom Checklist-Children (TRSC-C), reported by mothers of Puerto Rican children undergoing cancer treatments and identifying mothers' symptom alleviation/management strategies. Descriptive study conducted between January and May 2012. Mothers of 65 Puerto Rican children/adolescents undergoing cancer treatments responded to the Spanish versions of the TRSC-C, Symptom Alleviation: Self-Care Methods, and a Demographic and Health form. The children/adolescents' mean age was 9.2 (1-17) years; 62% were boys; 56 had chemotherapy; 9 had chemoradiotherapy. Children diagnoses were 35.4% leukemia, 24.6% solid tumors, 24.6% nervous system tumors, and 15.4% other. On the TRSC-C, the symptoms experienced by 70% or more of the children were: irritability (77%), nausea (75%), and hair loss (72%). On the Symptom Alleviation: Self-Care Methods, the most commonly reported symptom alleviation category was "taking prescribed medicines." Puerto Rican mothers reported the use of alleviation practices to treat their children experiencing symptoms during pediatric cancer treatments. Patients and caregivers need to be educated about treatment-induced side effects, and the life-threatening consequences of underreporting and undermanagement. Symptoms should always be addressed at the time of initiation of primary or adjuvant cancer therapy because pretreatment symptoms may persist or get worse across the trajectory of treatment. A continuous assessment and management of symptoms during the childhood cancer trajectory can optimize clinical care and improve quality of life of patients and families.

The development and application of an oncology Therapy-Related Symptom Checklist for Adults (TRSC) and Children (TRSC-C) and e-health applications.

BACKGROUND: Studies found that treatment symptoms of concern to oncology/hematology patients were greatly under-identified in medical records. On average, 11.0 symptoms were reported of concern to patients compared to 1.5 symptoms identified in their medical records. A solution to this problem is use of an electronic symptom checklist that can be easily accessed by patients prior to clinical consultations. PURPOSE: Describe the oncology Therapy-Related Symptom Checklists for Adults (TRSC) and Children (TRSC-C), which are validated bases for e-Health symptom documentation and management. The TRSC has 25 items/symptoms; the TRSC-C has 30 items/symptoms. These items capture up to 80% of the variance of patient symptoms. Measurement properties and applications with outpatients are presented. E-Health applications are indicated. METHODS: The TRSC was developed for adults (N = 282) then modified for children (N = 385). Statistical analyses have been done using correlational, epidemiologic, and qualitative methods. Extensive validation of measurement properties has been reported. RESULTS: Research has found high levels of patient/clinician satisfaction, no increase in clinic costs, and strong correlations of TRSC/TRSC-C with medical outcomes. A recently published sequential cohort trial with adult outpatients at a Mayo Clinic community cancer center found TRSC use produced a 7.2% higher patient quality of life, 116% more symptoms identified/managed, and higher functional status. DISCUSSION, IMPLICATIONS, AND FOLLOW-UP: An electronic system has been built to collect TRSC symptoms, reassure patients, and enhance patient-clinician communications. This report discusses system design and efforts made to provide an electronic system comfortable to patients. Methods used by clinicians to promote comfort and patient engagement were examined and incorporated into system design. These methods included (a) conversational data collection as opposed to survey style or standardized questionnaires, (b) short response phrases indicating understanding of the reported symptom, (c) use of open-ended questions to reduce long lists of symptoms, (d) directed questions that ask for confirmation of expected symptoms, (e) review of symptoms at designated stages, and (d) alerting patients when the computer has informed clinicians about patient-reported symptoms. CONCLUSIONS: An e-Health symptom checklist (TRSC/TRSC-C) can facilitate identification, monitoring, and management of symptoms; enhance patient-clinician communications; and contribute to improved patient outcomes.

A case-control study of pediatric falls using electronic medical records.

The purpose of this study was to retrospectively review Humpty Dumpty Falls Scale (HDFS) scores using electronic medical records (EMR) reports at a pediatric hospital to determine characteristics related to falls, injuries, and performance of the HDFS tool. The specific research question was: Is there a significant difference in HDFS total scores between cases (children who fell) and controls (those who did not fall)? Results from 74 cases and 242 controls revealed the number of falls did not differ significantly between those who obtained high HDFS scores and those who obtained low scores. HDFS sensitivity was 57%, specificity was 39%. The pediatric patients who fell were mostly oriented and ambulating; falls with injury did not exceed 19%. Future case-control studies should use larger sample sizes across multiple institutions with EMR capability.

Effects of patient teaching, educational materials, and coaching using telephone on dyspnea and physical functioning among persons with heart failure.

Heart failure (HF) is a major cause of death in Thailand and other developing countries. This study shows that a coaching using telephone program is an accessible and feasible strategy that helps patients with HF to self-manage HF symptoms, decrease dyspnea, and improve physical functioning at home.

Support programs for new graduates in pediatric nursing.

This study examined intent to stay and the relationship between work satisfaction and burnout in a sample of new registered nurse graduates hired at a freestanding children's hospital. The following research questions were addressed: (1) Two years after initial employment, what is the percentage of new graduates who intend to stay on the job? (2) Is there a relationship between work satisfaction and burnout? (3) What is the turnover rate after the implementation of a support group program for new registered nurses? Of a target group of 75 new graduate nurses, 33 (44%) completed a modified version of Aiken's Revised Nursing Work Index and the Maslach Burnout Inventory. A majority of the registered nurses intended to stay on the job, with 87.9% reporting that they were satisfied with their current position and 97.0% reporting that they were satisfied with being a nurse. The correlation between job satisfaction and burnout was as follows: r = -0.684, F(1,30) = -21.71; p < .001. Of the participants, 39% reported an increase in the amount of time they spent with patients over the year, 27% reported an increase in the amount of time they spent documenting patient care, and 24% reported that the "quality of care" they were providing was better than 1 year ago. Before the implementation of a support group program for new graduates in 2006, the turnover rate was 7.6%; in 2009, the turnover rate was 5.7%.

Symptom monitoring and dependent care during cancer treatment in children: pilot study.

Symptom monitoring by parents/caregivers of children with cancer and what the caregiver and child did to help alleviate symptoms during chemotherapy were studied. The Therapy-Related Symptom Checklist (TRSC) child version was administered to parents/caregivers of 11 children and adolescents (mean age, 10.4 years; SD, 6.1 years; range, 2-18 years; 45% were boys). The Karnofsky scale was completed by clinicians to rate the child's functional status. The TRSC child version and functional status scores were inversely related. All children experienced nausea; the most frequent symptoms reported were in TRSC subscales: fatigue, nausea, eating, fever, oropharynx, pain, and hair loss. Care strategies that helped were distraction, massage, mouth rinses, and vitamins; some reported that their child received medications for pain, nausea, and vomiting. Using complementary medicine categories, the care strategies were diet/nutrition/lifestyle change (eg, more high-fat, high-calorie foods; new foods; any food the child likes; and much sleep and rest); mind/body control (eg, play, video games, television, reading, activity puzzle, breathing exercises, relaxation methods, and prayer); manual healing method (massage and skin-to-skin contact); and biologic treatments (vitamins). The first 2 categories were the most used. Systematic assessment with a self-report checklist enables the provider to identify and prioritize (according to reported severity) those symptoms needing intervention.

Symptom alleviation and self-care among breast cancer survivors after treatment completion.

BACKGROUND: This article elucidates the symptom experiences of breast cancer survivors after completion of their treatment. It also provides self reports of the types, frequency of use, and effectiveness of self-care measures to treat the symptoms they are experiencing. OBJECTIVES: The purpose of this article is to describe the self-care strategies used to alleviate symptoms reported by breast cancer survivors recruited from a secure state coalition database. METHODS: The Therapy-Related Symptom Checklist (TRSC) was used to identify the occurrence and severity of ongoing symptoms in breast cancer survivors who were six months or more post-treatment. Two groups were identified for further exploration of self-care. FINDINGS: The self-care method category most commonly reported was diet/nutrition/lifestyle and the least common category was herbs/vitamins/complementary therapy. With few exceptions, the reported methods were perceived as effective.

Self-reported assessment of symptoms and self-care within a cohort of U.S. veterans during outpatient care for cancer.

BACKGROUND: This study was undertaken as part of a feasibility study of the use of a symptom checklist and self-care assessment of veterans receiving oncology outpatient treatment within the U.S. Department of Veterans Affairs system. OBJECTIVES: The study aimed to examine (a) symptom occurrence and severity as self-reported on the Therapy-Related Symptom Checklist (TRSC) by veterans at a cancer clinic, (b) symptom alleviation strategies and use of self-care, and (c) the relationship between symptom occurrence and severity and functional status and quality of life. METHODS: Veterans (N = 100) undergoing chemotherapy and/or radiation therapy participated in a cross-sectional study. Tools used, including TRSC, Symptom Alleviation. FINDINGS: Thirteen symptoms were reported by more than 35% of patients. Top-ranked symptoms by percentage occurrence and severity were feeling sluggish, taste changes, nausea, pain, constipation, loss of appetite, numbness of fingers and toes, difficulty sleeping, weight loss, hair loss, difficulty concentrating, shortness of breath, and decreased interest in sexual activity. Occurrence and severity of symptoms had significant negative correlations with functional status and with overall quality of life. Self-care (symptom alleviation) strategies that helped were medicines, diet and nutrition, and lifestyle change. Checklist use (TRSC) facilitated patient-report of symptoms during cancer treatments; self-care strategies helped relieve symptoms.

Monitoring and Alleviation of Symptom Occurrence and Severity Among Thai Children and Adolescents During Cancer Treatments.

BACKGROUND: Symptom monitoring and alleviation are important during pediatric cancer treatments. AIMS: To examine the use of the Therapy-Related Symptom Checklist for Children (TRSC-C; Thai version) for reported occurrence, severity, and management of treatment-related symptoms within a cohort of Thai pediatric oncology patients/parents METHOD: Cross-sectional study; convenience sample: 100 parents of 71 male children/29 females, 63% with leukemia, 37%, other diagnoses; age-groups: <5 years, n = 33; 5 to 11 years, n = 44; 12 to 17 years, n = 25. Parents reported children's symptom occurrence/severity on the TRSC-C; and complementary care methods on the Symptom Alleviation: Self-Care Methods and their symptom alleviation methods. All tools had good psychometric properties. RESULTS: 18 symptoms on the 30-item TRSC-C occurred in 42% to 95% of children. Mean severity of symptoms was between 1.0 ("a bit") and 2.0 ("quite a bit"); 5-month to 11-year-old children had higher (worse) TRSC-C total scores. Complementary care was used and reported. CONCLUSIONS: Monitoring of multiple symptoms with the TRSC-C and parental symptom alleviation helped children. CLINICAL IMPLICATIONS: Thai parents/patients need and accept assistance in monitoring/managing side effects of pediatric cancer therapy.

Symptom occurrence and severity on the therapy-related symptom checklist for children among Hispanic pediatric oncology outpatients.

BACKGROUND: A calibrated easy-to-use symptom checklist for children who are under treatment for cancer had been developed and reported in Cancer Nursing. The 30-item Therapy-Related Symptom Checklist for Children (TRSC-C) has good measurement and psychometric properties and uses "kid-friendly" terms to monitor symptom occurrence and severity during oncology treatment. A secondary analysis is reported using participants who self-identified as Hispanic. OBJECTIVE: The objective of this study was to examine among Hispanic pediatric oncology outpatients (a) occurrence and (b) severity of symptoms reported on the TRSC-C, (c) relationships of symptoms to gender and age (<12 vs ≥12), and (d) differences in summated TRSC-C symptom scores between patients with acute lymphoblastic leukemia (ALL) and other diagnoses. METHOD: This was a cross-sectional analysis using secondary data and descriptive statistics. SAMPLE: The sample was composed of 79 children (55% male) aged 5 to 17 years (mean, 10.3 years) with diagnosis of ALL (52%) or other (48%). Instrument used was TRSC-C by patient/parent report (Cronbach's α = .91). RESULTS: (a) Symptom occurrence: 15 symptoms on the TRSC-C were reported by 40% or greater. (b) Severity means on 11 symptoms were greater than "a little bit." (c) No gender or age differences were found on mean TRSC-C summated scores. (d) Mean TRSC-C scores (symptom occurrence and severity) were slightly lower but not significantly different (t = 1.71) between ALL (13.71 [SD, 8.06]) and other diagnoses (15.71 [SD, 7.01]). CONCLUSION: Symptom occurrence and severity reported on the TRSC-C by this Hispanic subsample are consistent with findings in the calibration study and with those of another Hispanic group and other ethnicities. IMPLICATIONS FOR PRACTICE: Use of the TRSC-C is appropriate during pediatric oncology treatment and diagnoses of Hispanic populations.

Symptom monitoring, alleviation, and self-care among Mexican Americans during cancer treatment.

Monitoring the occurrence and severity of symptoms among Mexican American adults undergoing cancer treatments, along with their self-care to alleviate symptoms, are understudied; the current study aimed to fill this gap in the literature. A total of 67 Mexican Americans receiving outpatient oncology treatments in the southwestern United States participated. Instruments included a patient-report checklist, the Therapy-Related Symptom Checklist (TRSC), the Symptom Alleviation: Self-Care Methods tool, and a demographic and health information form. At least 40% of participants reported the occurrence of 12 symptoms: hair loss, feeling sluggish, nausea, taste change, loss of appetite, depression, difficulty sleeping, weight loss, difficulty concentrating, constipation, skin changes, and numb fingers and toes. More than a third also reported pain, vomiting, decreased interest in sexual activity, cough, and sore throat. The helpful self-care strategies reported included diet and nutrition changes; lifestyle changes; and mind, body control, and spiritual activities. Patient report of symptoms during cancer treatments was facilitated by the use of the TRSC. Patients use symptom alleviation strategies to help relieve symptoms during their cancer treatment. The ability to perform appropriate, effective self-care methods to alleviate the symptoms may influence adherence to the treatment regimen.

Parental caregiving of children with cancer and family impact, economic burden: nursing perspectives.

Pediatric cancer diagnoses affect the entire family: parents, well siblings, the ill child, and others. The objective of this study was to review nursing studies on parental caregiving of children with cancer, family impact, and costs. The study used inclusion/exclusion criteria and family systems theory, self/dependent-care, and symptom management (monitoring, alleviation) concepts. Regarding "levels of evidence," 3 studies were Level II; 7 were Level IV; 7 were Level VI; 1 review was Level V and the second was Level I. Of 19 studies: 11 were qualitative; 4, quantitative; 2 were mixed methods. Content analysis themes were: Parental caregiving and family impact, economic burden. Conclusions were that (a) qualitative studies are predominant; findings supported quantitative findings; (b) quantitative nursing studies are less common: found one longitudinal, randomized controlled trial (RCT) focused on outcomes of an intervention for well siblings and parents, implemented by Clinical Nurse Specialists, CNSs; (c) few quantitative studies with large samples were found, especially ones with theoretical models of the family system and measures of illness impact on families; and (d) "mixed methods" longitudinal nursing research is illustrated. There is a need for "evidence-based" practice (EBP) nursing studies of interventions focused on parent education/support/assistance; respite care, and increasing family/well sibling knowledge/other information on the child's illness.

Repiphysis prosthesis for limb preservation in pediatric patients with bone cancer: a literature review.

Osteosarcoma is the most common bone sarcoma in children and adolescents. It occurs mainly around the knee joint; the distal femur is the most common location. When it occurs in children who are skeletally immature, a significant limb length discrepancy can occur. The Repiphysis prosthesis was developed in the 1980s to assist in reconstruction of the affected limb in these patients. Ten articles were reviewed to identify the challenges and complications that affect the functional outcome on this population. The reports included patients, aged 7-16 years, who were skeletally immature and had bone sarcomas of the lower extremities. Complications reported by the authors were similar and included aseptic loosening, mechanical failure, infection, flexion contracture of the knee, fracture, and neuropraxia.

Relationships among therapy-related symptoms, depressive symptoms, and quality of life in Chinese children hospitalized with cancer: an exploratory study.

BACKGROUND: Recent advances in cancer screening and treatment have resulted in a decrease in mortality rates in children and adolescents. However, despite the improved prognosis, the course of cancer treatment continues to be a very stressful experience in the life of a child. OBJECTIVES: The objectives of the study were to assess the occurrence and severity of treatment-related symptoms manifested by children and adolescents undergoing active cancer treatment and to examine the relationships between therapy-related symptoms, depressive symptoms, and quality of life of these pediatric patients. METHODS: A cross-sectional study design was used, and 135 Hong Kong Chinese children (9- to 16-year-olds) who were admitted for treatment of cancer in a pediatric oncology unit were invited to participate in the study. RESULTS: Results indicated that children and adolescents receiving combined cancer treatment generally experienced greater symptom occurrence and severity. In addition, children reporting greater symptom occurrence and severity experienced higher levels of depression and a lower level of quality of life. The study revealed that therapy-related symptoms are a strong predictor of quality of life of children and adolescents hospitalized for cancer treatment. CONCLUSIONS: Cancer and its treatments significantly affect the psychosocial well-being and quality of life of children and adolescent hospitalized for cancer care. Therapy-related symptoms can be a useful indicator for screening those pediatric patients who are likely to exhibit psychosocial distress or are at high risk of depression. IMPLICATIONS FOR PRACTICE: It is essential for nurses to be sensitive and knowledgeable about the therapy-related symptoms of cancer treatment and their effects on children and adolescents to promote the psychosocial well-being of these patients and enhance their quality of life.

Confirmatory factor analysis of the Chinese version of the Pediatric Quality-of-Life Inventory Cancer Module.

BACKGROUND: Before the Chinese version of the Pediatric Quality-of-Life Inventory Cancer Module can be used to assess the multidimensional construct of quality of life among Hong Kong Chinese pediatric patients with cancer, its psychometric properties need to be further empirically tested. OBJECTIVE: The objectives of the study were to establish the construct validity, including hypothesis testing and a confirmatory factor analysis of factor structure, of the Chinese version of the Pediatric Quality-of-Life Inventory Cancer Module. METHODS: A cross-sectional study was used; 200 children hospitalized with cancer (9- to 16-year-olds) were recruited. Participants were asked to respond to the Chinese version of the Cancer Module, Therapy-Related Symptom Checklist, and Rosenberg's Self-esteem Scale. RESULTS: The results showed that there was a strong positive correlation between children's self-esteem and quality of life (r = 0.50) and a strong negative correlation between children's therapy-related symptoms and quality of life (r = -0.65). Confirmatory factor analysis indicated that there were 7 factors underlying the Chinese version of the Cancer Module. CONCLUSION: The study added further evidence of the construct validity of the Chinese version of the Cancer Module, patient version. IMPLICATION FOR PRACTICE: The Cancer Module can be used to assess and evaluate psychological interventions directed toward promoting the quality of life of children hospitalized with cancer.

Therapy-related symptom checklist use during treatments at a cancer center.

BACKGROUND: Cancer treatment efficacy has improved with therapies at high or sustained dosages. However, there is increasing concern about symptom management and patients' quality of life. OBJECTIVE: The objective of this study was to assess whether use of a Therapy-Related Symptom Checklist (TRSC) with oncology outpatients increases the number of symptoms documented and managed and whether this improves patients' health-related quality of life (HRQOL). METHODS: This was a sequential cohort trial. Fifty-five oncology outpatients in treatment received standard of care (group 1, G1). Afterward, another 58 patients (group 2, G2) received standard of care at the same clinic; however, these patients additionally answered the TRSC immediately prior to each consultation. The TRSC results were then shared with clinicians. Repeated measures (2-11 visits) were obtained of the number of patient treatment symptoms documented (medical records G1 and TRSC G2), HRQOL, and Karnofsky scores, n = 696 observations (328 G1 and 368 G2). The number of symptoms reported and HRQOL were covariate adjusted using population averaged generalized estimating equations. RESULTS: G2 patients had a 7.2% higher population averaged covariate-adjusted HRQOL than G1 patients (3.3 more points on HRQOL, P = .012). One hundred sixteen percent more covariate- and non-covariate-adjusted symptoms were documented/managed in G2 than G1 (6.14 symptoms vs 2.84, P < .0001). The HRQOL, TRSC, and Karnofsky scores correlated r > 0.40. CONCLUSION: Use of patient-reported TRSC improves symptom documentation/management and patient HRQOL. IMPLICATIONS FOR PRACTICE: Study findings were consistent with recent research that has shown that use of checklists can have powerful influences on both quality and safety of healthcare services and patient outcomes.

A symptom checklist for children with cancer: the Therapy-Related Symptom Checklist-Children.

BACKGROUND: Symptom monitoring and alleviation are basic to the care of children and adolescents with cancer. A symptom checklist helps facilitate this process. OBJECTIVES: The primary objective of this study was to calibrate a child-friendly, clinically usable checklist capturing symptom occurrence and severity; a secondary objective was to examine age group differences: 5 to 11 years (n = 222) and 12 to 17 years (n = 163) and sex differences: males (54%) and females (46%), and correlate symptom severity, functional status, and quality of life. METHODS: Three hundred eighty-five children/adolescents at 5 university-affiliated outpatient oncology clinics: central, western, eastern, southeastern United States. Diagnoses were acute lymphoblastic leukemia (45%), solid tumors (14%), nervous system tumors (18%), and others (23%). Principal component factor analysis, confirmatory factor analysis, correlational statistics, t test, Wilcoxon test were performed. RESULTS: (a) Robust 30-item checklist, 7 factors; (b) 14 of 30 symptoms reported by at least 40% of patients. Top 5 are feeling sluggish (77%), nausea (72%), appetite loss (66%), irritable (61%), and vomiting (54%). (c) Sixteen of 30 symptoms reported at severity 2 or greater: "quite a bit." (d) Therapy-Related Symptom Checklist-Children (TRSC-C) scores are as follows: range, 0 to 89; mean, 25.14 (SD, 18.68). (e) Cronbach α = .9106. (f) Older children reported greater symptom severities: TRSC-C (t = 2.73, P = .003). (g) There were no sex differences on the TRSC-C total score. (h) Lansky correlations with TRSC-C (r = -0.32; P = .02); factors: nutrition related (r = -0.36; P = .05); oropharyngeal (r = -0.51; P = .0002); and respiratory (r = - 0.25; P = .06). (i) Pediatric Quality of Life Inventory correlation with TRSC-C (r = -0.68; P = .0001). CONCLUSION: The new TRSC-C has good measurement properties and is ready for use in clinics and research. IMPLICATIONS FOR PRACTICE: Use of the TRSC-C is consistent with guidelines emphasizing self-report of patient symptoms, shared patient decision making, and improved communications among patients, clinicians, and significant others.

An intervention to manage patient-reported symptoms during cancer treatment.

Patients with cancer receiving therapy may face a variety of complicated and stressful symptoms. Oncology nurses can advocate for patients by performing their roles as educators and comanagers of cancer-related side effects. In addition, symptom-focused education provided by oncology nurses can enable patients to administer self-care more effectively.

Cancer therapy-related symptoms and self-care in Thailand.

PURPOSE: The aim of the study was to examine patient-reported symptoms and self-care strategies in Thai patients with cancer. METHODS: The study was descriptive using a cross-sectional design. It was carried out at the National Cancer Institute, Thailand (Bangkok; Lopburi). 202 patients undergoing combined radiotherapy and chemotherapy (RT-CT), n=52; or CT alone, n=103; or RT alone, n=47 participated. Data was collected with the use of a 25-item Therapy-Related Symptom Checklist, TRSC (Thai); a Self-Care Method scale; the Karnofsky Scale, and a Health Data form. RESULTS: Patients on combined RT-CT reported more symptoms on the TRSC, with greater severity than those receiving RT or CT alone (F=7.2; p<0.01); and lower Karnofsky score (F=4.2, p<0.05); Karnofsky and TRSC scores were inversely correlated. Using complementary care categories, self-care methods reported were six types: (a) Diet/nutrition/life-style changes (e.g. modify food) to manage Eating and Fatigue symptoms; (b) Mind/Body Control to relieve Fatigue and other symptoms; (c) Biologic treatment (e.g. vitamins) for eating difficulties; (d) Herbal treatments for hair loss; (e) Other methods, and (f) taking prescribed medicines to control pain and other symptoms. Some patients reported "doing nothing" as coping. CONCLUSIONS: Self-care including complementary care use as an adjunct to cancer treatments could help patients deal with the side effects of therapy. Assessment of symptoms using the TRSC (Thai) version and their alleviation could enable the health care providers to enhance patients' coping during cancer treatments.

Symptom monitoring and self-care practices among Filipino cancer patients.

The purpose of this study was to assess patient-reported symptoms and self-care methods used during cancer treatments, using checklists. A descriptive study was performed at the cancer institute of a national medical center in Manila on 100 patients undergoing combined radiotherapy and chemotherapy, n = 37, or chemotherapy alone, n = 63. Instruments used were (a) 25-item patient-reported Therapy-Related Symptoms Checklist (TRSC), (b) Self-care Methods (with the 25 TRSC items) tool, (c) Karnofsky Scale, (d) Demographic form, and (e) Health form. The TRSC (Philippine version) Cronbach alpha = .83. The TRSC scores inversely, significantly correlated with nurse-rated Karnofsky measure of functional status (r = -0.45; P < .001)-all evidences of internal consistency reliability, construct, and concurrent validity; similar findings were found in Midwestern United States and 2 other Asian settings. Compared with those receiving chemotherapy alone, patients who had combined radiotherapy and chemotherapy reported more symptoms with greater severity on several TRSC subscales. Self-care methods most used were in 2 categories: (a) diet/nutrition/lifestyle change (eg, modify food/eating habits; eat vegetables and fruits (papaya); use nutritional supplements; have naps, rest, sleep) to manage eating, oropharynx, nausea, and fatigue subscale symptoms; and (b) mind/body control (eg, prayer, praying the rosary, music) to relieve fatigue subscale, other symptoms. The TRSC (Philippine version) and Self-care Methods assess patient-reported symptoms and patients' self-care use. Oncology symptom management is enhanced by a valid clinical assessment tool.