Nurse-led Symptom Clinic
Self-Assessment Test
Edmonton Symptom Assessment System-Revised

Below is the self-assessment test result for the Symptom feeling in the past week:
(0: Not at all; 10: Extreme feeling)

Pain
0
1
2
3
4
5
6
7
8
9
10
Tiredness = lack of energy
0
1
2
3
4
5
6
7
8
9
10
Drowsiness = feeling sleepy
0
1
2
3
4
5
6
7
8
9
10
Nausea
0
1
2
3
4
5
6
7
8
9
10
Lack of appetite
0
1
2
3
4
5
6
7
8
9
10
Shortness of breath
0
1
2
3
4
5
6
7
8
9
10
Depression = feeling sad
0
1
2
3
4
5
6
7
8
9
10
Anxiety = feeling nervous
0
1
2
3
4
5
6
7
8
9
10
Wellbeing = how your feel overall (0 = Feeling Good, 10 = Feeling worst ever)
0
1
2
3
4
5
6
7
8
9
10
Sleeping difficulty
0
1
2
3
4
5
6
7
8
9
10
Numbness/tingling in hands and feet
0
1
2
3
4
5
6
7
8
9
10
Other problem
0
1
2
3
4
5
6
7
8
9
10