Concordance of cancer patient and caregiver symptom reports

This study investigated whether family caregiver reports of cancer patients' symptoms (specifically: nausea, pain, poor appetite, insomnia, fatigue, cough, constipation, and diarrhea) were in concordance with patient reports, and whether variables such as patient depression, caregiver depression, caregiver optimism, and perceived impact of caring on caregiver health would explain discrepancies in patients' and caregivers' reports.

A sample of 216 patients and their family caregivers was recruited through six community-based cancer treatment centers located in lower Michigan. Data on the study variables were obtained from two separate, multifaceted survey instruments completed by the patients and their family caregivers, respectively.

The rate of agreement between patient and caregiver was highest for fatigue and lowest for insomnia, whether the entire sample, male caregivers, or female caregivers were considered. Female caregivers had a higher percentage agreement with their patients, and a higher level of association between patient and caregiver responses than male caregivers, uniformly for all symptoms. The overall accuracy of caregiver reports was approximately 71% and seemed to be relatively independent of the number of symptoms reported by the patient.

Health professionals caring for patients with cancer must recognize that patient and caregiver reports of patient symptoms may not always be in agreement. Awareness of variables that may cloud family caregivers' observations is needed, so that accurate symptom reporting occurs, and appropriate management can be initiated to enhance quality of life for the patient as much as possible. It is also important for health professionals to educate family caregivers about the nuances of symptom distress presentation and to teach caregivers techniques to elicit accurate information so that timely, appropriate palliative management can be initiated.