Division of Palliative Care, Department of Internal Medicine I, Medical University of Vienna, Währinger Gürtel, Wien, Austria.
Eur J Oncol Nurs. 2013 Feb;17(1):70-4. doi: 10.1016/j.ejon.2012.01.005. Epub 2012 Feb 26.
Discrepancies exist in estimation of quality of life (QL) by patients and caregivers but underlying factors are incompletely characterised.
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.
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).
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.
患者和护理人员对生活质量(QL)的评估存在差异,但潜在因素尚未完全阐明。
在一项横断面研究中,153 名患者由自己、70 名护士和 53 名医生对 QL 进行了评估。评估了可能影响评分者间一致性的变量。
患者与护士以及患者与医生之间的 QL 评分者间一致性为中等(r=0.292)。当与 Karnofsky 指数(KI)>50 的患者相比时,KI<50 的患者的疲劳和疼痛的评分者间一致性与护士之间的差异具有统计学意义(r=0.154)。他们与医生的疲劳、疼痛和身体功能的评分者间一致性明显降低。女性患者的焦虑程度评分者间一致性显著更好(p=0.009)。男性患者的社会援助需求(p=0.01)和身体功能(p=0.03)的评分者间一致性明显更好。男性护士和男性医生对患者身体功能的评估与患者的一致性明显更高(p=0.03,r=0.944),而女性护士和女性医生的一致性则较低(p=0.03,r=0.674)。
我们的研究表明,专业护理人员对患者整体 QL 的评估不准确。评分者间的一致性受患者 KI、患者和护理人员的性别以及护士的专业经验影响。