Memorial Symptom Assessment Scale

Construct: Care-recipient and/or caregiver perceptions of symptoms and distress

Cancer patientDescription of Measure: The Memorial Symptom Assessment Scale is an instrument designed to assess common physical symptoms experienced by persons with cancer (Portenoy et al, 1994; McMillan et al., 2006), although these symptoms are also common in other conditions and at the end-of-life. The recommended version of the scale is an adaptation by McMillan et al., that can be administered either to care-recipients or caregivers. It includes 24 items for which the caregiver or care-recipient report on whether a symptom (e.g., pain, lack of energy, shortness of breath) occurred during the previous week, as well as any distress it may have caused. If administered to patients, the scale provides a measure of the care-recipient’s perceptions of their symptoms, including which are most distressing. When given to caregivers, it indicates the symptoms of which they have an awareness, including those of highest priority to them. Occurrence is documented on a Yes/No basis. Distress is measured on a 5-point rating scale. While individual items should be examined to identify the symptoms that are most stressful, the scale also has excellent psychometric properties, including alpha coefficients of over .9 (McMillan & Small, 2002).


McMillan, S. C., Small, B. J., Weitzner, M., Schonwetter, R. S., Tittle, M., Moody, L., & Haley, W. E. (2006). Impact of coping skills intervention with family caregivers of hospice patients with cancer: a randomized clinical trial. Cancer, 106, 214- 222.

McMillan, S.C. & Small, B.J. (2007). Using the COPE intervention for family caregivers to improve symptoms of hospice homecare patients: a clinical trial. Oncology Nursing Forum, 34(2),313-321.

McMillan, S.C., & Small, B. (2002). Symptom distress and quality of life in hospice patients with cancer. Oncology Nursing Forum, 29(10), 1421-1428.

Portenoy, R.K., Thaler H.T., Kornblith A.B., Lepore J.M., Friedlander-Klar, H., Kiyasu , E., Sobel, K., Coyle, N., Kemeny, N., & Norton L., (1994). The Memorial Symptom Assessment Scale: an instrument for the evaluation of symptom prevalence, characteristics and distress. European Journal of Cancer, 30A(9), 1326-1336.