Quality of life in end-stage renal disease patients: differences in patient and spouse perceptions.
Quality of life in end-stage renal disease patients: differences in patient and spouse perceptions.
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DOI：
10.1080/13607860902845558
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发表时间：
2009-09
影响因子：
3.4
通讯作者：
Pruchno RA
中科院分区：
文献类型：
--
作者：
Ferri CV;Pruchno RA
配偶和其他代理人对患者生活质量（QOL）的评价始终低于患者自己。在终末期肾病（ESRD）、癌症、中风和其他慢性疾病中观察到这种模式，但尚未得到解释。本文的目的是研究配偶和患者对终末期肾病患者生活质量的评价的相似性和差异。终末期肾病患者及其配偶参加了基线和一年的随访访谈。患者及其配偶均对患者的QOL、情绪、功能能力、主观健康和肾脏疾病症状进行评分。配偶也评价自己的QOL。配偶将所有患者特征（包括QOL）评定为比患者差。患者的情绪和他们的主观健康的看法的变化预测患者和配偶的患者生活质量的评级。配偶对患者功能能力的看法的变化预测了患者生活质量的配偶评分，但不是患者自己的评分。最后，配偶自身生活质量的变化解释了他们对患者生活质量的评价的额外差异。患者和配偶对患者生活质量和患者生活质量的预测因素的看法不同。影响包括需要意识到配偶的生活质量和其他心理变量的患者评级的负面偏见，特别是当配偶的看法被认为是由医疗保健专业人员。在临床环境中与患者和配偶讨论患者和配偶感知的差异将使患者状态得到更全面的了解。
Spouses and other proxies consistently rate patient quality of life (QOL) lower than patients rate it themselves. This pattern has been observed in end-stage renal disease (ESRD), cancer, stroke and other chronic illnesses, but it has not been explained. The purpose of the current paper is to examine similarities and differences in spouse and patient ratings of the QOL of patients with ESRD. Patients with ESRD and their spouses participated in baseline and one-year follow-up interviews. Both patients and spouses rated the patient’s QOL, mood, functional ability, subjective health, and kidney disease symptoms. Spouses also rated their own QOL. Spouses rated all patient characteristics, including QOL, as worse than did the patient. Change in perceptions of patient’s mood and their subjective health predicted both patient and spouse ratings of patient QOL. Change in spouse’s perceptions of patient’s functional ability predicted spouse ratings of patient QOL, but not the patient’s own ratings. Finally, change in the spouse’s own QOL explained additional variance in their rating of the patient’s QOL. Patients and spouses perceive patient QOL and predictors of patient QOL differently. Implications include the need to be aware of negative bias in spouse ratings of patients of QOL and other psychosocial variables, especially when spouse perceptions are considered by health care professionals. Discussing differences in patient and spouse perceptions in clinical settings with both patients and spouses will allow for a more comprehensive understanding of patient status.
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