Do Patients and Physicians Agree When They Assess Quality of Life?

Barata, Anna; Martino, Rodrigo; Gich, Ignasi; García‐Cadenas, Irene; Abella, Eugènia; Barba, Pere; Briones, Javier; Brunet, Salut; Esquirol, Albert; García-Pallarols, Francesc; Garrido, Ana; Granell, Miguel; Martinez, Jaume; Mensa, Irene; Novelli, Silvana; Sánchez‐González, Blanca; Valcárcel, David; Sierra, Jordi

doi:10.1016/j.bbmt.2017.03.015

Cited by 13 publications

(7 citation statements)

References 41 publications

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“…However, their evaluations were suboptimal in areas that were more concealed, even when the evaluation was done immediately after the relevant discussion. These results demonstrate outcomes that are in line with the previous studies' findings [ 15 , 18 , 21 , 37 ]. There is an evident communication gap, and clinicians need to pay special attention to these hidden problems.…”

Section: Discussionsupporting

confidence: 92%

“…Although the agreement levels have been varied, many studies agree that caregivers generally overestimate the patients' problems [8,11,13,15]. Researchers have found that healthcare providers have different tendencies as compared to caregivers; healthcare providers' perspectives deviated more from the patients', [16][17][18] and often underestimated their problems [19][20][21][22][23]. Patient factors such as age and severity of symptoms are all possible influences that affect the agreement between proxies [15,17,18,20,23,24].…”

Section: Introductionmentioning

confidence: 99%

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Communication in Oncology Outpatient Clinic Settings: Congruence of Quality of Life Assessment between Patient-Physician and Patient-Caregiver Dyads

Tang

Chen

et al. 2022

Journal of Oncology

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Context. Exploring the congruence of health-related quality of life (HRQOL) evaluation provides valuable information regarding whether proxies can accurately reflect patient perceptions and the quality of symptom communication. It is particularly important in advanced cancer population who experience poor HRQOL and have deteriorated ability to express their feelings. Objectives. The aims of this study were to investigate the congruence of HRQOL reports between patient-physician and patient-caregiver dyads and to determine the association of variables, if any, with the congruence between dyads. Methods. This correlational study with a cross-sectional design first approached physicians who provided care for patients with advanced cancer at the participating institution. Then, participating physicians’ patients and their caregivers were recruited. All participants were required to independently fill out an HRQOL questionnaire during their outpatient visits. Descriptive statistics, weighted kappa, Wilcoxon signed-rank test, and linear regression were employed for data analysis. Results. A total of 52 patient-physician and 27 patient-caregiver dyads were examined. Patients suffered from considerable problems in all three HRQOL domains: symptom, functioning, and overall HRQOL. The patients’ level of agreement was moderate with the caregivers and fair with the physicians. A significant relationship was found between several patient-related variables and disagreement. Conclusion. These patients with advanced cancer experienced a compromised HRQOL, warranting immediate attention. When there are barriers to obtaining a patient’s self-report, clinicians may consider caregivers as a reasonable source. Patients with special characteristics need additional attention because their problems may be at a greater risk of being overlooked.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Communication in Oncology Outpatient Clinic Settings: Congruence of Quality of Life Assessment between Patient-Physician and Patient-Caregiver Dyads

Tang

Chen

et al. 2022

Journal of Oncology

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“…There is strong evidence supporting the value of incorporating standardized psychosocial screening into practice. In the absence of a psychosocial assessment, providers are likely to grossly underestimate patient and family emotional and social distress [8]. Adult HCT patients who receive psychosocial screening are more likely to have a discussion with their providers regarding psychological symptoms and indicate that they prefer psychosocial screening at future visits [9].…”

Section: Introductionmentioning

confidence: 99%

Screening for Family Psychosocial Risk in Pediatric Hematopoietic Stem Cell Transplantation with the Psychosocial Assessment Tool

Pai

Swain

Chen

et al. 2019

Biology of Blood and Marrow Transplantation

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Family psychosocial risk screening is an important initial step in delivering evidence-based care in hematopoietic stem cell transplantation (HCT). Establishing an evidence-based screening approach that is acceptable, reliable, and valid is an essential step in psychosocial care delivery. This is a 3-institution multimethod study. In part 1, caregivers of children about to undergo HCT (n = 140) completed the Psychosocial Assessment ToolÀHematopoietic Cell Transplantation (PAT-HCT), a brief parent report screener adapted for HCT, and validating questionnaires. Families received feedback on their risks identified on the PAT-HCT. In part 2, 12 caregivers completed a semistructured interview about their perceptions of the PAT and the feedback process. The reliability and validity of the PAT-HCT total and subscale scores were tested using Kuder-Richardson-20 (KR-20) and Pearson correlations. Thematic content analysis was used to analyze the qualitative interview data. Internal consistency for the total score (KR-20 = .88) and the Child Problems, Sibling Problems, Family Problems, and Stress Reactions subscales were strong (KR-20 >.70). Family Structure, Social Support, and Family Beliefs subscales were adequate (KR-20 = .55 to .63). Moderate to strong correlations with the criteria measures provided validation for the total and subscale scores. Feedback was provided to 97.14% of the families who completed the PAT-HCT, and the mean rating of acceptability was >4.00 (on a 5-point scale). The qualitative data indicate that families appreciate the effort to provide screening and feedback. The PAT-HCT is a psychometrically sound screener for use in HCT. Feedback can be given to families. Both the screener and the feedback process are acceptable to caregivers.

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“…In contrast, most previous studies reporting on patient-reported (toxicity) measures used cross-sectional data. 31,32 Furthermore, we included a large sample and a homogeneous group of patients that participated in a multicenter trial. Finally, we provided a solid basis for improving future reporting of toxicity by offering a new set of tools consisting of patient self-reported cumulative toxicity scores that correlate well with patients' QoL.…”

Section: Discussionmentioning

confidence: 99%

Impact of Patient- and Clinician-Reported Cumulative Toxicity on Quality of Life in Patients With Metastatic Castration-Naïve Prostate Cancer

Schuurhuizen¹,

Marino²,

Braamse³

et al. 2018

J Natl Compr Canc Netw

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Background: Current toxicity evaluation is primarily focused on high-grade adverse events (AEs) reported by clinicians. However, the cumulative effect of multiple lower-grade AEs may also impact patients' quality of life (QoL). Further, patient-reported toxicity may be more representative of patients' treatment experiences. This study aimed to determine whether cumulative toxicity comprising all-grade AEs is more associated with QoL than cumulative toxicity comprising high-grade AEs only, and whether patient-reported cumulative toxicity is more associated with QoL than clinician-reported cumulative toxicity. Methods: Patients with metastatic castration-naïve prostate cancer participating in the phase III GETUG-AFU 15 trial completed questionnaires on AEs (at 3 and 6 months) and QoL (at baseline and 3 and 6 months). Clinicians reported AEs during clinical visits. Cumulative toxicity scores were calculated for clinicians and patients in 3 ways: total number of high-grade AEs, total number of all-grade AEs, and total number of all AEs multiplied by their grade (severity score). Relationships between cumulative toxicity scores and QoL were studied using longitudinal regression analyses; unstandardized (B) and standardized regression coefficients (β) are reported. Results: Of 385 patients, 184 with complete QoL and toxicity data were included. Clinician-reported all-grade AEs (B, -2.2; 95% CI, -3.3 to -1.1; P<.01) and severity score (B, -1.4; 95% CI, -2.2 to -0.7; P<.01) were associated with deteriorated physical QoL, whereas the total number of high-grade AEs was not. All patient-reported scores were significantly (P<.01 for all) associated with deteriorated physical and global QoL. Standardized regression coefficients indicated that patient-reported toxicity scores were more associated with QoL outcomes than clinician-reported scores, with the strongest association found for the all-grade AEs and severity cumulative toxicity scores. Conclusions: Patient-and clinician-based cumulative toxicity scores comprising all-grade AEs better reflect impact on patient QoL than toxicity scores comprising high-grade AEs only. To assess the effect of toxicity on QoL, patient-reported cumulative toxicity scores are preferred.

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Do Patients and Physicians Agree When They Assess Quality of Life?

Cited by 13 publications

References 41 publications

Communication in Oncology Outpatient Clinic Settings: Congruence of Quality of Life Assessment between Patient-Physician and Patient-Caregiver Dyads

Communication in Oncology Outpatient Clinic Settings: Congruence of Quality of Life Assessment between Patient-Physician and Patient-Caregiver Dyads

Screening for Family Psychosocial Risk in Pediatric Hematopoietic Stem Cell Transplantation with the Psychosocial Assessment Tool

Impact of Patient- and Clinician-Reported Cumulative Toxicity on Quality of Life in Patients With Metastatic Castration-Naïve Prostate Cancer

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