PURPOSE: This study reports how QOL (quality of life) assessments differ between patients on prolonged mechanical ventilation (PMV) and their proxies (family caregivers and nurses). METHODS: We enrolled consecutive subjects on PMV for more than 21 days from five institutions. We conducted QOL assessments using the Taiwanese version of the EQ-5D in face-to-face interviews. Direct caregivers (family members and nurses) also completed the EQ-5D from the patient's point of view. RESULTS: For 55 of the 142 enrolled patients who were able to assess their QOL, we recruited 44 patient-family caregiver pairs, 53 patient-nurse pairs, and 42 family caregiver-nurse pairs. There were 81 family caregiver-nurse pairs out of 87 patients with poor cognition. The agreement between patient-family caregiver pairs was generally higher than that of patient-nurse pairs. As the proportions of exact agreement between family caregivers and nurses for patients with poor cognition were 98-99% for observable dimensions of mobility, self-care, and usual activities, they lead to a minimal difference in the final values. CONCLUSIONS: QOL assessments from family caregivers agreed more closely with patients than did those from nurses using EQ-5D evaluations for patients with clear cognition, but either proxy was acceptable for rating PMV patients with poor cognition.
PURPOSE: This study reports how QOL (quality of life) assessments differ between patients on prolonged mechanical ventilation (PMV) and their proxies (family caregivers and nurses). METHODS: We enrolled consecutive subjects on PMV for more than 21 days from five institutions. We conducted QOL assessments using the Taiwanese version of the EQ-5D in face-to-face interviews. Direct caregivers (family members and nurses) also completed the EQ-5D from the patient's point of view. RESULTS: For 55 of the 142 enrolled patients who were able to assess their QOL, we recruited 44 patient-family caregiver pairs, 53 patient-nurse pairs, and 42 family caregiver-nurse pairs. There were 81 family caregiver-nurse pairs out of 87 patients with poor cognition. The agreement between patient-family caregiver pairs was generally higher than that of patient-nurse pairs. As the proportions of exact agreement between family caregivers and nurses for patients with poor cognition were 98-99% for observable dimensions of mobility, self-care, and usual activities, they lead to a minimal difference in the final values. CONCLUSIONS: QOL assessments from family caregivers agreed more closely with patients than did those from nurses using EQ-5D evaluations for patients with clear cognition, but either proxy was acceptable for rating PMVpatients with poor cognition.
Authors: Liam M Hannan; David G T Whitehurst; Stirling Bryan; Jeremy D Road; Christine F McDonald; David J Berlowitz; Mark E Howard Journal: Qual Life Res Date: 2017-03-02 Impact factor: 4.147
Authors: Robert A Fowler; Nicole Mittmann; William H Geerts; Diane Heels-Ansdell; Michael K Gould; Gordon Guyatt; Murray Krahn; Simon Finfer; Ruxandra Pinto; Brian Chan; Orges Ormanidhi; Yaseen Arabi; Ismael Qushmaq; Marcelo G Rocha; Peter Dodek; Lauralyn McIntyre; Richard Hall; Niall D Ferguson; Sangeeta Mehta; John C Marshall; Christopher James Doig; John Muscedere; Michael J Jacka; James R Klinger; Nicholas Vlahakis; Neil Orford; Ian Seppelt; Yoanna K Skrobik; Sachin Sud; John F Cade; Jamie Cooper; Deborah Cook Journal: Trials Date: 2014-12-20 Impact factor: 2.279