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Do palliative patients and carers agree about patients' psychological functioning?
Julie Ann Robinson1, Gregory Brian Crawford
1School of Psychology, Flinders University, Adelaide, SA 5001, South Australia. julie.robinson@flinders.edu.au
Palliative & Supportive Care
|February 19, 2010
Summary
Patient and family caregiver reports on cognition and depression show substantial discrepancies. Clinicians should not substitute caregiver information for patient reports in palliative care settings.
Area of Science:
- Palliative Care
- Geriatric Medicine
- Clinical Psychology
Background:
- Palliative care relies on accurate patient information for effective treatment.
- Family caregivers are often used as collateral sources for patient data.
- The agreement between patient and caregiver reports requires empirical investigation.
Purpose of the Study:
- To assess the agreement between patient and family caregiver reports on cognitive function and depression in advanced cancer patients.
- To determine if caregiver reports can substitute for patient reports in palliative care.
Main Methods:
- Sixty-six advanced cancer patients and their family caregivers participated.
- Cognitive performance was assessed using the Mini-Mental State Examination and caregiver reports.
- Depression was measured using patient and caregiver-completed Geriatric Depression Scales.
Main Results:
- While patient and caregiver reports were related, significant discrepancies were observed.
- Magnitude of discrepancies in reporting on cognition and depression was substantial.
- No measure showed sufficient agreement to justify substituting caregiver for patient reports.
Conclusions:
- Empirical evidence does not support substituting collateral source information for patient-reported data on cognition or depression.
- Collateral source information is best used when patient data is compromised or for specific assessment goals.
- Multi-informant approaches are recommended for comprehensive patient assessment in palliative care.
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