One instrument used in palliative care is the Edmonton Symptom Assessment Scale (ESAS), which consists of 8 visual analog scales (VAS) ranging from 0–100 mm, indicating the levels of pain, activity, nausea, depression, anxiety, drowsiness, appetite, sensation of well-being,[26] and sometimes shortness of breath.[27] A score of 0 indicates absence of the symptom, and a score of 10 indicates the worst possible severity.[27] The instrument can be completed by the patient, with or without assistance, or by nurses and relatives.[26]