Incorporating standardized HRQL assessments in daily clinical oncology practice facilitates the discussion of HRQL issues and can heighten physicians' awareness of their patients' HRQL.

Although both patients and oncologists seem willing to discuss a wide range of HRQL issues, communication regarding psychosocial issues may be hampered by competing expectations as to who should take the lead in initiating such discussions.

This study indicated considerable variation between countries in the prevalence of those perceiving themselves to be victims of bullying but also revealed a clear profile of those likely to be bullied. The study also suggests that the Kidscreen bullying scale could be useful in identifying potential bullying victims.

Background: Knowledge about psychometric properties of the Pediatric Quality of Life Inventory (PedsQL) in the Netherlands is limited and Dutch reference data are lacking. Aim of the current study is to collect Dutch reference data of the PedsQL and subsequently assess reliability, sociodemographic within-group differences and construct validity.

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Summary This study examined the usefulness of caregiver ratings of cancer patients' quality of life (QOL), an issue of relevance to bot h adequate patient care and to the possible use of proxy QOL raters in clinical studies.We compared QOL ratings of 90 cancer pat ients receiving inpatient chemotherapy with those provided by their significant others (most often the spouse), physicians and nurses . During patients' scheduled appointment for receiving chemotherapy on a clinical ward, all raters completed independently the Dartmouth COOP Functional Health Assessment charts/WONCA, an instrument developed by a cooperative group of primary care physicians to briefly assess a core set of seven QOL domains (physical fitness, feelings, daily and social activities, overall health, pain and quality of l ife) by single items with five response options. With few exceptions, mean scores of the proxy raters were equivalent or similar to those of the pat ients. Most patient-proxy correlations varied between 0.40 and 0.60, indicating a moderate level of agreement at the individual level. Of a ll comparisons made, 41% were in exact agreement and 43% agreed within one response categor y, leaving 17% more profound patient-proxy discrepancies. Disagreement was not dependent on the type of proxy rate r, or on raters' background characteristics, but was inf luenced by the QOL dimension under consideration and the clinical status of the patient. Better patient-proxy agreement was observed for m ore concrete questions (daily activities, pain) and for patients with either a very good (ECOG 0) or poor (ECOG 3) performance status. The r esults indicate that both significant others and health care providers can be useful sources of information about cancer patients' QOL.

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Despite increasing recognition of the importance of maintaining patients' HRQL as a goal of palliative treatment, the amount of patient-physician communication devoted to such issues remains limited and appears to make only a modest contribution, at least in an explicit sense, to the evaluation of treatment efficacy in daily clinical practice.