Symptoms of patients hospitalized because of malignancy : a comparison of the perceptions of the patient, the next of kin, and the nurse

Eaton, Bill, 1951- (1999) Symptoms of patients hospitalized because of malignancy : a comparison of the perceptions of the patient, the next of kin, and the nurse. Masters thesis, Memorial University of Newfoundland.

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Abstract

The aim of this descriptive study was to assess, using Cohen's Kappa statistic, the agreement between hospitalized patients with cancer and their closest family member, and between these patients and the nurse providing the bedside care, on the perceptions of cancer-related symptoms. -- One hundred patients, hospitalized because of a malignancy, rated nine cancer-related symptoms using the Edmonton Symptom Assessment System, a collection of nine Visual Analogue Scales. Simultaneously, the closest family member and the nurse providing the bedside care rated the patients' symptoms using the same method. The aim of the study was to assess agreement, on these nine symptoms, between the patients and the family members, and between the patients and their nurses. -- Family members demonstrated significant agreement (Cohen's Kappa > 0.35) with the patient in assessment of nausea, anxiety, drowsiness, tiredness, and appetite; but not for pain, depression, shortness of breath, or overall well-being. The nurses demonstrated significant agreement with the patient on the perception of nausea only. -- Merging the nine reported similar studies on symptom agreement between patient and family with the present study there emerges no consistent evidence on agreement for pain, shortness of breath, well-being, anxiety, and appetite; while there is good evidence to suggest agreement on nausea, depression, tiredness, and drowsiness. -- Similarly, reviewing the two studies involving cancer patients and nurses, there emerged no consistent evidence on the agreement for pain, nausea, tiredness, drowsiness, or appetite. While the previous studies did not assess shortness of breath, anxiety, and well-being, there was over-estimation by the nurses on the patient's ratings of depression. -- CONCLUSIONS: -- 1) Family members agreed with the patients in their perceptions of five out of nine cancer-related symptoms: nausea, anxiety, drowsiness, tiredness, and appetite. -- 2) Family members did not agree with the patients on the symptoms of: pain, depression, shortness of breath, and well-being. -- 3) Nurses agreed with the patients in their perceptions of one out of nine (nausea) cancer related symptoms. -- 4) Family members were closer in their perceptions of the cancer patients' symptoms than were the nurses.

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