Assessing symptoms of terminally-ill patients by different raters: A prospective study

Abstract

Significant differences for nurses and physicians were found on the sum-score level for psychological and social symptoms, but not for physical and functional symptoms. Family members rated the intensities of the symptoms generally higher than the patients. Suggestions for further analyses are presented and discussed.

Assessing Health-Related Quality of Life in the Greek Home Health Care Setting

“…[4][5][6] Our results support previous reports that no overestimation was found with regard to the subjective symptoms and dimensions of the QoL. 5,9,10 A small degree of the underestimation of patients' QoL by nurses may be the result of the instructions that they were given about the way they would fill the questionnaires. 20 Quality of life has also become a crucial focus in oncology nursing practice and research.…”

“…The influence of the patients' functional status is confirmed in various ways by the literature. 5,10,12,14,16,28 Ubel et al mention 29 that nurses, like other healthy people, have a general tendency to overestimate problems related to a serious illness/disability and underestimate the patients' capability to handle and face a serious illness/disability and also underestimate the patients' health-related QoL. So, in-depth communication with the bedridden patients is imperative, for the assessment of their QoL and its dimensions to be more accurate.…”

“…6 Comparisons between patient and proxy assessments can detect the caregiver's ability to perceive and interpret the patient's condition. 10 An incorrect assessment of the symptoms may lead to administering an overdose or insufficient medication 16 and maybe the logical consequence of errors in the evaluation is inadequate treatment. 9,11 Limitations Our study has several limitations.…”

“…We considered the patients' assessment as the gold standard in comparison with the nurses' assessment, as the best judge of a patient's QoL is the patient himself or herself. 4 However, this assumption may introduce biases 10,24 (adaptation process, social desirability, vulnerability avoidance).…”

Assessment of Cancer-Related Pain

“…Additionally, many symptoms or problems were reported more often by the patients than by their doctors or nurses [11,12]. According to the scientific literature, the concordance between patient self-assessment and proxy ratings of various medical and personal attendants is far from perfect and differs most of all in psychosocial aspects [13]. This discrepancy between proxy and self-assessment forms the starting point of the work of Budischewski et al [14] who present in this issue the results of their cross-sectional study on the burden of pain of inpatients undergoing radiotherapy.…”