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

Mei R. Fu, Roxanne W. McDaniel, Verna A. Rhodes

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish (US)
Pages (from-to)623-634
Number of pages12
JournalJournal of Advanced Nursing
Issue number6
StatePublished - Sep 2007


  • Instrument development
  • Nursing
  • Symptom Experience Index
  • Symptom distress
  • Symptom experience
  • Symptom management
  • Symptom occurrence

ASJC Scopus subject areas

  • General Nursing


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