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Edmonton Symptom Assessment System Revised Renal (ESASr: Renal) Please circle the number that best describes how you feel NOW: No Pain012345678910Worst Possible PainNo Tiredness012345678910Worst Possible Tiredness012345678910Worst.

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How to fill out the Edmonton Symptom Assessment System Revised Renal (ESAS-r) online

The Edmonton Symptom Assessment System Revised Renal (ESAS-r) is an essential tool for assessing the symptoms of individuals with renal conditions. This guide provides clear instructions on how to fill out the ESAS-r form online, ensuring that users can complete the assessment accurately and efficiently.

Follow the steps to complete the form successfully.

  1. Press the ‘Get Form’ button to access the form. This will open the document in your chosen online editor.
  2. Begin by circling the number that best describes how you feel right now for each symptom listed. The scale ranges from 0 (no symptom) to 10 (worst possible symptom) for categories including pain, tiredness, drowsiness, and others.
  3. Make sure to complete the entire section by assessing and marking each symptom area accurately, reflecting your current feelings for tiredness, nausea, lack of appetite, shortness of breath, depression, anxiety, wellbeing, itching, sleeping problems, and restless legs.
  4. For any additional problems not listed, use the space provided to describe the issue and rate it on the same scale.
  5. Fill in your name, the date of completion, and the time. Ensure the date format is yyyy-Mon-dd, and the time format is hh:mm.
  6. Indicate who completed the form by checking the appropriate option: Patient, Family Caregiver, Health Care Professional Caregiver, or Caregiver-assisted.
  7. Review your responses for accuracy before finalizing the document.
  8. Once completed, you can save your changes, download the form, print it, or share it as needed for your records or with healthcare providers.

Complete the Edmonton Symptom Assessment System Revised Renal (ESAS-r) online today to assess your symptoms effectively.

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A questionnaire used to rate the intensity of nine common symptoms experienced by cancer patients, including pain, tiredness, nausea, depression, anxiety, drowsiness, appetite, well-being and shortness of breath.

Purpose of the ESAS This tool is designed to assist in the assessment of: pain, tiredness, nausea, depression, anxiety, drowsiness, appetite, well being, and shortness of breath. One blank scale is available for patients to use to assess an “other problem” as needed.

The total ranges from 0 to 60, with a higher score indicating higher physical symptom burden. Combined score based on ESAS anxiety and depression. The total ranges from 0 to 20, with a higher score indicating higher emotional symptom burden.

How? The patient should be instructed to rate the severity of each symptom on a 0 to 10 scale, where 0 represents absence (or best possible intensity) of the symptom and 10 represents the worst possible severity. The number should be circled on the scale. The circled numbers can be transcribed onto the ESAS-r graph.

Purpose: The Edmonton Symptom Assessment System-Revised: Renal (ESAS-r: Renal) is a disease-specific patient-reported outcome measure (PROM) that assesses symptoms common in chronic kidney disease (CKD).

The ESAS-r retains the core elements of the ESAS (nine common symptoms, option of adding a tenth symptom, 11-point numerical rating scales), with key revisions focusing on symptom assessment time frame, terminology, item order, and format (see Methods for detailed description).

The ESAS assesses the severity over time of nine symptoms common among patients with cancer and other advanced illness: pain, tiredness, drowsiness, nausea, shortness of breath, appetite, depression, anxiety, and wellbeing.

What is the Edmonton Symptom Assessment Scale (ESAS)? The ESAS is a tool that was developed to help assess nine symptoms that are common in palliative care patients: pain, tiredness, drowsiness, nausea, lack of appetite, depression, anxiety, shortness of breath, and wellbeing.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232