Family Caregivers' assessment of symptoms in patients with advanced cancer: Concordance with patients and factors affecting accuracy
Family Caregivers' assessment of symptoms in patients with advanced cancer: Concordance with patients and factors affecting accuracy
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DOI：
10.1016/j.jpainsymman.2007.02.038
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发表时间：
2008-01-01
影响因子：
4.7
通讯作者：
Brajtman, Susan
中科院分区：
文献类型：
--
作者：
McPherson, Christine J.;Wilson, Keith G.;Brajtman, Susan
这项研究的目的是检查患者和家庭照顾者对患者症状的评估之间的一致性，并确定影响一致性水平的人口统计学和心理社会因素。60名接受姑息治疗的晚期癌症患者和他们的主要非正式照顾者使用纪念症状评估量表(MSA)评估患者的症状。对个别症状的一致性水平从差到优(组间相关系数为0.07-0.75)。使用配对t检验对组内均值进行分析，发现MSAS子量表(心理、身体和一般痛苦指数)以及12种身体症状中的4种和6种心理症状中的5种存在显著差异。观察到的差异的大小表明照顾者高估的程度是轻微到中等的偏向，这在心理上比在身体症状上更明显。在某些衡量标准上，与照顾者(特别是情绪状态、提供护理的负担和男性性别)和患者(对他人构成负担的感觉)相关的一些因素与差异程度显著相关。这一发现与越来越多的关于代理受访者对患者症状评估的有效性的文献相一致。
The purposes of the study were to examine the concordance between patients' and family caregivers' assessments of patients' symptoms, and to identify demographic and psychosocial factors that affect levels of agreement. Sixty-.six patients with advanced cancer receiving palliative care, and their primary, informal caregivers assessed patients' symptoms using the Memorial Symptom Assessment Scale (MSAS). Levels of agreement for individual symptoms ranged from poor to excellent (interclass correlation coefficient 0.07-0.75). Analysis of the group means using paired t-tests revealed significant differences for the MSAS subscales (psychological, physical, and general distress index), and, for four of the 12 physical symptoms and five of the six psychological symptoms. The magnitude of the observed differences indicated a small to moderate bias for caregivers to overestimate, which was more marked for psychological than for physical symptoms. A number of factors associated with the caregiver (particularly the emotional state, the burden of providing care, and male gender) and the patient (the perception of being a burden to others) were significantly correlated with levels of disparity on some measures. The findings are consistent with the growing body of literature on the validity of proxy respondents' assessments of patients' symptoms.