School of Psychology, Flinders University, Adelaide, SA 5001, South Australia.
Palliat Support Care. 2010 Mar;8(1):69-74. doi: 10.1017/S1478951509990721. Epub 2010 Feb 18.
Palliative care clinicians and researchers often seek information about patients from informants. This research examines the extent of agreement between information from patients and family caregivers who were asked to serve as collateral sources of information about the patient.
Sixty-six patients with advanced cancer and their family caregivers participated in the study. Two measurement contexts were examined: Direct observation of patients' cognitive performance (Mini-Mental State Examination) was compared with carers' subjective reports about patients' everyday cognition (Cognitive Decline subscale of the Psychogeriatric Assessment Scale), and subjective reports about patient depression were compared between patients and carers who completed parallel forms of the same scale (Geriatric Depression Scale and Geriatric Depression Scale-Collateral Source, respectively). The relationship between patient-completed and carer-completed measures was examined in four ways: the correlation between total scores in the sample, agreement about the prevalence of impaired functioning and of specific symptoms in the sample, agreement concerning whether particular patients showed impaired functioning, and agreement about the presence or absence of a specific symptom for a particular patient.
Although most measures of agreement showed that information provided by patients and carers was related, the magnitude of discrepancies was substantial.
There was no empirical justification for substituting information from a collateral source for information provided by the patient for any of the measures of agreement for either cognition or depression. The use of information from collateral sources is most appropriate when information from the patient is likely to be incomplete or inaccurate, when insight into caregivers' needs or understanding is sought, and when using a multi-informant approach to assessment.
姑息治疗临床医生和研究人员经常向知情者寻求有关患者的信息。本研究旨在调查要求作为患者信息的间接来源的患者和家庭护理者所提供的信息之间的一致性程度。
66 名患有晚期癌症的患者及其家庭护理者参与了这项研究。考察了两种测量情境：直接观察患者的认知表现（迷你精神状态检查）与护理者对患者日常认知的主观报告（心理老年评估量表的认知减退子量表）进行比较，以及患者和护理者完成相同量表的平行形式（老年抑郁量表和老年抑郁量表-间接来源）之间的患者抑郁主观报告进行比较。通过以下四种方式来检查患者完成的和护理者完成的测量之间的关系：样本中总分之间的相关性、样本中功能障碍和特定症状的发生率的一致性、是否特定患者表现出功能障碍的一致性，以及特定患者特定症状的存在或缺失的一致性。
尽管大多数一致性测量表明患者和护理者提供的信息是相关的，但差异的幅度很大。
对于任何认知或抑郁的一致性测量，都没有经验依据可以替代患者提供的信息而使用间接来源的信息。当患者的信息可能不完整或不准确时，当需要了解护理者的需求或理解时，以及当使用多信息源评估方法时，使用间接来源的信息是最合适的。
Zotero 插件