title: Symptom assessment in hospitalized older palliative patients with cancer: agreement among patients, nurses, and proxies.
abstract: OBJECTIVE
  To evaluate the level of agreement of symptom assessment among older adult palliative patients with cancer, nurses, and patients' proxies.
  
  
  METHODS
  A cross-sectional study.
  
  
  METHODS
  Two general hospitals in Flanders, Belgium.
  
  
  METHODS
  120 palliative patients with cancer, aged 65 years and older.
  
  
  METHODS
  A validated 36-item instrument developed to assess physical, psychological, functional, social, and existential symptoms in older palliative patients with cancer was independently completed by patients, the nurses, and proxies.
  
  
  METHODS
  Frequency and intensity of 36 symptoms.
  
  
  RESULTS
  The study indicates that nurses and proxies tend to underestimate physical and social symptoms and overestimate psychological, functional, and existential symptoms. Agreement scores between patients and nurses and patients and proxies were only significantly different in 39% and 20% of the cases, respectively. Higher intraclass correlation coefficients were measured between patients and proxies compared to patients and nurses. Agreement was associated with demographic and clinical factors, such as gender and prognosis.
  
  
  CONCLUSIONS
  This study indicates discrepancies among patient, nurse, and proxy in the assessment of symptoms.
  
  
  CONCLUSIONS
  Patients should be encouraged to report their true experiences. Nurses and proxies should be taught to recognize and assess symptoms and to communicate about them with patients.
authors: Ghent University.
authors: Aurélie
authors: A
authors: Lancker
authors: Ghent University.
authors: Stephanie
authors: S
authors: Cypers
authors: Ghent University.
authors: Elke
authors: E
authors: Vanwynsberghe
authors: Ghent University.
authors: Sofie
authors: S
authors: Verhaeghe
authors: Ghent University.
authors: Ann
authors: A
authors: Hecke
authors: Ghent University.
authors: Dimitri
authors: D
authors: Beeckman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium; D003430:Cross-Sectional Studies; D005260:Female; D006769:Hospitals, General; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D009369:Neoplasms / Q000451:nursing / Q000523:psychology*; D009726:Nurses / Q000523:psychology*; D009730:Nursing Assessment; D015588:Observer Variation; D010166:Palliative Care; D019727:Proxy / Q000523:psychology*; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D063189:Symptom Assessment
keywords: neoplasms; palliative care; signs and symptoms; symptom assessment