Confidant and breast cancer patient reports of quality of life

It is well known that breast cancer patients report a temporary decline in their quality of life following diagnosis. Caregivers observe these changes, but only a few studies have examined the shared perceptions of patients and others concerning the patient's QOL. In this study, 112 women (96% white, 4% Native American), ages 34-84, rated their QOL 1-3 months after diagnosis on the Functional Assessment of Cancer Therapy (FACT). The patients identified their main source of emotional support, and this confidant also completed the FACT. Most participants selected a spouse (60%); others selected a child (11%), friend (11%), or sibling (7%). Comparisons on five QOL subscales showed good agreement between patients and their confidants, with an average patient-confidant correlation across subscales of r = 0.34. At baseline, patients reported a higher overall QOL (M = 90.30) than their confidants (87.32), p = 0.05. At a 4-month follow up, significant patient/confidant difference was only obtained for the emotional well being subscale. Overall, the data attest to the reliability of the FACT, but they also suggest that confidants may overestimate how distressed patients feel, or that patients are reluctant to admit to distress. Such discrepancies could cause misguided social support efforts.