Jacobs Daniel I, Kumthekar Priya, Stell Becky V, Grimm Sean A, Rademaker Alfred W, Rice Laurie, Chandler James P, Muro Kenji, Marymont MaryAnne, Helenowski Irene B, Wagner Lynne I, Raizer Jeffrey J
Department of Neurology, Northwestern University , Chicago, Illinois (D.I.J., P.K., B.V.S., S.A.G., L.R., J.J.R.); Department of Preventive Medicine Northwestern University , Chicago, Illinois (A.W.R., I.B.H.); Department of Neurosurgery Northwestern University , Chicago, Illinois (J.P.C., K.M.); Department of Radiation Oncology , Northwestern University , Chicago, Illinois (M.M.); Medical Social Sciences , Northwestern University , Chicago, Illinois (L.I.W.).
Neurooncol Pract. 2014 Jun;1(2):47-54. doi: 10.1093/nop/npu004. Epub 2014 May 5.
Given the neurocognitive impairment experienced by many patients with malignant gliomas, caregiver reports can be critical in assessing the quality of life (QOL) of these patients. In this study, we explored whether assessment of patient QOL by the primary caregiver shows concordance with the patient's self-reported QOL, and we quantified the burden faced by caregivers.
QOL of 45 patients was evaluated by both the patient and primary caregiver on 3 or more separate occasions using the Functional Assessment of Cancer Therapy-Brain (FACT-Br) instrument, and concordance between the 2 reports was evaluated. Caregiver burden was measured using the Caregiver Quality of Life Index-Cancer (CQOL-C) instrument.
Overall, good concordance was observed between the patient and caregiver FACT-Br reports (intraclass correlation coefficient = 0.74). Patient-reported FACT-Br scores were 4.75 (95% CI, 1.44-8.05) points higher than paired caregiver reports on the 200-point scale ( = .008); however, this difference did not achieve clinical significance. Caregiver burden, as measured by the CQOL-C, was significantly greater among caregivers in this study than those previously reported for caregivers of patients with lung, breast, or prostate cancer ( < .001).
Despite minor discrepancies in caregiver assessments of patient QOL relative to patient self-reports, our results suggest that the caregiver assessments can serve as adequate proxies for patient reports. Our results also illustrate the particularly heavy burden faced by caregivers of patients with malignant glioma. Further research into both of these areas is warranted.
鉴于许多恶性胶质瘤患者存在神经认知障碍,照料者的报告对于评估这些患者的生活质量(QOL)至关重要。在本研究中,我们探讨了主要照料者对患者生活质量的评估与患者自我报告的生活质量是否一致,并对照料者所面临的负担进行了量化。
45名患者的生活质量由患者和主要照料者在3次或更多次单独的场合使用癌症治疗功能评估-脑(FACT-Br)工具进行评估,并评估两份报告之间的一致性。使用照料者生活质量指数-癌症(CQOL-C)工具测量照料者负担。
总体而言,患者和照料者的FACT-Br报告之间观察到良好的一致性(组内相关系数=0.74)。在200分制中,患者报告的FACT-Br得分比配对的照料者报告高4.75分(95%CI,1.44-8.05)(P=.008);然而,这种差异未达到临床显著性。通过CQOL-C测量的照料者负担在本研究中的照料者中显著高于先前报道的肺癌、乳腺癌或前列腺癌患者的照料者(P<.001)。
尽管照料者对患者生活质量的评估与患者自我报告存在微小差异,但我们的结果表明,照料者的评估可以作为患者报告的适当替代。我们的结果还说明了恶性胶质瘤患者的照料者所面临的特别沉重的负担。对这两个领域都有必要进行进一步的研究。