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Level of agreement between patient self-report and observer ratings of health-related quality of life communication in oncology

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Author: Hilarius, D.L. · Kloeg, P.H.A.M. · Detmar, S.B. · Muller, M.J. · Aaronson, N.K.
Institution: TNO Preventie en Gezondheid
Source:Patient Education and Counseling, 1, 65, 95-100
Identifier: 239813
doi: doi:10.1016/j.pec.2006.06.002
Keywords: Health · Communication research · Health-related quality of life · Level of agreement · Observer ratings · Patient self-report · Cancer center · Cancer chemotherapy · Cancer fatigue · Cancer patient · Cognition · Consultation · Demography · Observation · Observational study · Outpatient care · Prevalence · Quality of life index · Sample size · Self report · Sleep disorder · Social interaction · Statistical analysis · Adult · Aged · Ambulatory Care · Antineoplastic Agents · Attitude of Health Personnel · Attitude to Health · Communication · Data Collection · Female · Hospitals, Community · Humans · Male · Medical Oncology · Middle Aged · Neoplasms · Netherlands · Nurse-Patient Relations · Nursing Assessment · Nursing Evaluation Research · Nursing Methodology Research · Nursing Staff, Hospital · Oncologic Nursing · Quality of Life


Objective: To determine the level of agreement between patients and observers regarding the frequency with which health-related quality of life topics are discussed during outpatient clinical oncology visits. Methods: The sample (n = 50) consisted of a consecutive series of cancer patients undergoing chemotherapy. Both the patients and observers used a checklist to report which HRQL topics had been discussed during the consultation. Percentage of agreement, kappa and adjust-kappa statistics were calculated. Results: The percentage agreement between patients' and observers' ratings was generally high, ranging from 74% for fatigue to 96% for sleep problems and cognitive functioning. The average percentage of agreement over the 13 HRQL topics rated was 86%. Cohen's kappa varied between 0.41 (for pain) and 0.78 (for sleep problems). Prevalence-adjusted kappa's were generally higher, ranging from 0.48 (for fatigue) to 0.92 (for sleep problems and social functioning). The average Cohen's kappa and prevalence-adjusted kappa over the 13 HRQL topics were 0.56 and 0.71, respectively. Level of agreement was not found to vary significantly as a function of patients' background characteristics. Conclusion: Oncology patients' self-reports of the HRQL-related topics discussed during outpatient chemotherapy visits are in reasonably close agreement with those provided by observers. Practice implications: Our results indicate that the patient is a legitimate source of information about the HRQL-related content of medical encounters, and thus can be used in communication studies where the collection of observational data (e.g., via audio- or videotaping) is either too costly or logistically impractical. © 2006 Elsevier Ireland Ltd. All rights reserved. Chemicals / CAS: Antineoplastic Agents