Concordance between patient and family caregiver reports of quality of colorectal cancer care.

Authors

null

Rachel D. Havyer

Mayo Clinic, Rochester, MN

Rachel D. Havyer, Michelle van Ryn, Patrick Wilson, Joan M. Griffin

Organizations

Mayo Clinic, Rochester, MN

Research Funding

NIH

Background: Patient-reported evaluations of interpersonal quality of care are essential elements of quality of cancer care assessment. At times, patients may be unable to report themselves on their care experience and systems may rely on proxy reports. The validity of this approach is dependent on the degree to which family caregiver assessments are concordant with patient assessments. Methods: A VA cohort of colorectal cancer (CRC) patients and their caregivers both completed a self-administered questionnaire on the quality of VA cancer care in 3 specific domains: surgery, chemotherapy overall and chemotherapy nursing care, all measured on a 5-point Likert scale. Because the kappa statistic penalizes skewed distributions which are commonly seen in patient satisfaction reports, agreement between patients and caregivers on perceptions of quality care were measured using Gwet’s AC2 statistic. Stratified analyses on caregiver burden, race, education, and age as well as patient’s stage of disease were used to assess variation in agreement. Results: 417 caregiver-patient dyads completed the survey (70% response rate), of whom 362 (86.8%) had surgery and 195 (46.8%) had chemotherapy. Overall agreement was high for the 3 quality of care domains: AC2 (95% CI): 0.870 (0.838, 0.903) for surgery, 0.835 (0.786, 0.884) for chemotherapy overall and 0.906 (0.868, 0.944) for chemotherapy nurses. Stratified analyses of agreement showed particular populations of higher or lower agreement; however the findings were inconsistent across the three domains and most were not statistically significant. Patients with lower stage (I-II) had higher agreement than higher stages (III-IV) (AC2: 0.967 and 0.879 respectively, P = 0.006) but only in the chemotherapy nurses domain. For the surgery domain, age was the only significant difference in agreement (0.816, 0.912, and 0.838 for < 50, 51-65, and > 65 respectively, P = 0.03). Conclusions: Family caregiver reports on the quality of CRC care were highly concordant with patient reports. Therefore, family caregivers may be able to provide reasonable proxy report on measures of quality of cancer care when patient reports are unavailable.

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Abstract Details

Meeting

2016 Palliative and Supportive Care in Oncology Symposium

Session Type

Poster Session

Session Title

Poster Session A

Track

Evaluation and Assessment of Patient Symptoms and Quality of Life,Integration and Delivery of Palliative Care in Cancer Care

Sub Track

Quality improvement activities

Citation

J Clin Oncol 34, 2016 (suppl 26S; abstr 187)

DOI

10.1200/jco.2016.34.26_suppl.187

Abstract #

187

Poster Bd #

K13

Abstract Disclosures

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