Rotterdam Symptom Checklist for Cancer

Purpose: To evaluate the distress caused by symptoms in a with cancer using the Rotterdam Symptom Checklist.

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Evaluation

Are you evaluating the distress caused by symptoms in a patient with cancer?

Yes

Select the appropriate answer for the occurrence of each symptom during the past week

Lack of appetite

Irritability

Tiredness

Worrying

Sore muscles

Depressed mood

Lack of energy

Low back pain

Nervousness

Nausea

Desperate feelings about the future

Difficulties sleeping

Headaches

Dizziness

Decreased sexual interest

Tension

Abdominal ache

Anxiety

Heartburn, belching

Shivering

Tingling hands or feet

Difficulty concentrating

Sore mouth, pain on swallowing

Loss of hair

Burning or sore eyes

Shortness of breath

Dry mouth

Results

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Results Interpretation and Description References Next Steps

Data complete?

Evaluation appropriate?

Psychological distress subscore

Physical distress subscore

Total distress score

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Caution: A qualified health practitioner should verify all results.
Keep patient data confidential and comply with all legal requirements.

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Interpretation and Description

References

Next Steps in Evaluation

Diagnosis

Severity, Prognosis, Stage
- Performance Status of Eastern Cooperative Oncology Group (ECOG) for Cancer (Zubrod Scale)

Monitoring

Disease Progression
- Quality of Life Assessment for Patient Receiving Chemotherapy for Lung Cancer

Patient Concerns

Disability And Performance
- Lansky Play Performance Scale for Children with Cancer
- Functional Independence Measure (FIM) Score
Quality Of Life
- Quality of Life for Patient Receiving Palliative Care
- Quality of Life Assessment for Patient Receiving Chemotherapy for Lung Cancer
End-of-life, Palliative Care
- Quality of Life for Patient Receiving Palliative Care

Objective

clinical diagnosis
including family history for genetics
disability and performance
psychological response

ICD-10

C00-D49 - Neoplasms

Info

Purpose: To evaluate the distress caused by symptoms in a with cancer using the Rotterdam Symptom Checklist.

Objective: clinical diagnosis, including family history for genetics, disability and performance, psychological response

ICD-10: C00-D49,

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