Is breathlessness what the professional says it is? Analysis of patient and professionals' assessments from a German nationwide register

Simon ST, Altfelder N, Alt-Epping B, Bausewein C, Weingärtner V, Voltz R, Ostgathe C, Radbruch L, Lindena GU, Nauck F (2014)

Publication Status: Published

Publication Type: Journal article, Original article

Publication year: 2014

Journal

Supportive Care in Cancer Springer

Book Volume: 22

Pages Range: 1825-1832

Journal Issue: 7

DOI: 10.1007/s00520-014-2131-5

Abstract

Purpose: Breathlessness is a common and distressing symptom in patients with advanced disease. Patients' self-report is deemed to be the most valid method of symptom assessment. When patients are not capable of self-assessment, professionals' assessment is often used as alternative but evidence on the validity is conflicting. The aim of this study was to compare self- and professionals' assessment of breathlessness regarding presence and severity in patients with advanced disease. Methods: Secondary analysis of a cross-sectional, multi-centre and nationwide register (HOspice and Palliative Care Evaluation (HOPE)). Documented inpatients from hospices and palliative care units from 2006 to 2008 who completed the self-assessed MInimal DOcumentation System (MIDOS) were included. Professionals' assessment were based on the integrated symptom and problem checklist (symptom scores, 0-3). Cohen's kappa (κ) was used to estimate the 'level of agreement' (LoA). Results: Two thousand six hundred twenty-three patients (mean age, 66.9 (SD, 12.8); 54.4 % female; median Eastern Cooperative Oncology Group score, 3; 95.9 % with malignant disease) were analysed. Prevalence of breathlessness was 53.4 % (1,398 patients) by professionals' and 53.1 % (1,410 patients) by self-assessment. Presence was correctly evaluated by professionals in 80.9 % of cases (sensitivity, 81.8 %; specificity, 79.8 %). Severity of breathlessness was correctly estimated in 65.7 % of cases. LoA was good (κ=0.62) for the evaluation of presence of breathlessness and moderate (κ=0.5) for the estimation of severity. The proportion of over- or underestimated scores was similar. Conclusions: If patient's self-rating, the gold standard of symptom assessment, is not possible, professionals' assessment might be a valid alternative, at least for assessing the presence of breathlessness. © 2014 Springer-Verlag.

Authors with CRIS profile

Christoph Ostgathe Department of Palliative Medicine

Involved external institutions

Universitätsklinikum Göttingen DE Germany (DE) Universitätsklinikum Köln DE Germany (DE) Klinikum der Universität München DE Germany (DE) Universitätsklinikum Bonn DE Germany (DE) CLARA Klinische Forschung DE Germany (DE)

How to cite

APA:

Simon, S.T., Altfelder, N., Alt-Epping, B., Bausewein, C., Weingärtner, V., Voltz, R.,... Nauck, F. (2014). Is breathlessness what the professional says it is? Analysis of patient and professionals' assessments from a German nationwide register. Supportive Care in Cancer, 22(7), 1825-1832. https://doi.org/10.1007/s00520-014-2131-5

MLA:

Simon, Steffen T., et al. "Is breathlessness what the professional says it is? Analysis of patient and professionals' assessments from a German nationwide register." Supportive Care in Cancer 22.7 (2014): 1825-1832.

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