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Patients and staff perceptions of cancer patients' quality of life
Birgit Hladschik-Kermer1, Katharina A Kierner, Ursula Heck
1Division of Palliative Care, Department of Internal Medicine I, Medical University of Vienna, Währinger Gürtel, Wien, Austria.
Background:
Discrepancies exist in estimation of quality of life (QL) by patients and caregivers but underlying factors are incompletely characterised.
Methods:
QL of 153 patients was estimated by themselves, by 70 nurses and by 53 physicians in a cross-sectional study. Variables which could influence inter-rater agreement were evaluated.
Results:
Inter-rater agreement of QL was fair (r = .292) between patients and nurses and between patients and physicians (r = .154). Inter-rater agreement with nurses was significantly lower concerning fatigue and pain for patients with a Karnofsky Index <50 when compared to patients with a KI > 50. Their inter-rater agreement with physicians was significantly lower for fatigue, pain and physical functioning. Agreement on the degree of anxiety was significantly (p = .009) better for female patients. Agreement on the need for social assistance (p = .01) and physical functioning (p = .03) was significantly better for male patients. Agreement with patients on their physical functioning was significantly (p = .03) better for male nurses and male physicians (r = .944) than for female nurses and female physicians (r = .674).
Conclusions:
Our study showed that estimation of overall QL of patients by professional caregivers is inaccurate. Inter-rater agreement was influenced by KI of patients, by gender of patients and caregivers and by professional experience of nurses.
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