Proxy Reporting in Five Areas of Functional Status: Comparison with Self-Reports and Observations of Performance

Magaziner, Jay; Zimmerman, Sheryl; Gruber‐Baldini, Ann L.; Hebel, J. Richard; Fox, Kathleen M.

doi:10.1093/oxfordjournals.aje.a009295

Cited by 199 publications

(184 citation statements)

References 52 publications

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“…In general, the greater the significant other's contact or involvement with the patient the better the agreement (25,26). Greater involvement can be expected to increase knowledge of the patient and therefore enhance the accuracy of ratings.…”

Section: Patient and Proxy Ratings Of Patient Qlmentioning

confidence: 99%

Proxy ratings of patient quality of life Factors related to patient–proxy agreement

Essén¹

2004

Acta Oncologica

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It is generally agreed that patients are the best raters of their quality of life (QL). Where it is not possible to obtain information from the patient the use of proxies can be an alternative. The proxy can be a significant other or a healthcare provider. The use of a proxy offers a solution to non-response. The accuracy of proxy reports is most typically determined by examining the extent to which patient and proxy ratings agree. A literature overview shows that agreement depends on several factors. Methodological limitations may have an impact on agreement. Agreement also varies according to the QL domains under study; the highest agreement is usually found for concrete domains. In addition, patient and proxy characteristics are related to agreement. When designing QL studies the threat of selection bias due to exclusion of patients has to be balanced against the threat of information bias due to proxy ratings.

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Section: Patient and Proxy Ratings Of Patient Qlmentioning

confidence: 99%

Proxy ratings of patient quality of life Factors related to patient–proxy agreement

Essén¹

2004

Acta Oncologica

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“…8 Although proxy respondents are known to overestimate disability, this effect is small for observable activities such as mobility. 9 We felt it was important to include respondents who used a proxy as they represent the most vulnerable older adults. Access to the MCBS data was obtained through a data use agreement with CMS, and the study was approved by the University of Pittsburgh Institutional Review Board.…”

Section: Introductionmentioning

confidence: 99%

Ability to Walk 1/4 Mile Predicts Subsequent Disability, Mortality, and Health Care Costs

et al. 2010

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“…The literature consistently shows that family proxies report worse health-related quality of life (HRQOL) and functioning for conditions such as stroke (3, 4), cancer (5), dementia (6, 7), and general health conditions (8) when compared to self-report measures from patients. Although several studies have shown that mild to moderately impaired patients with dementia can provide reliable self-report information about their health and well-being (6, 9-11), family members are frequently viewed as the primary source of patient status information (12).…”

Section: Introductionmentioning

confidence: 99%

Magnitude and Causes of Bias Among Family Caregivers Rating Alzheimer Disease Patients

Schulz

Cook

Beach

et al. 2013

The American Journal of Geriatric Psychiatry

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Objective Family caregivers generally underestimate the health and well-being of Alzheimer’s disease (AD) patients when compared to patient self-assessments. The goals of this study were to identify caregiver, patient, and contextual factors associated with caregiver rating bias. Methods 105 patients with AD and their family caregivers were assessed twice by trained interviewers one year apart. In separate interviews, caregivers were asked to rate the quality of life and suffering of their patient relative, and patients provided self-ratings using the same structured instruments. Multivariate cross-sectional and longitudinal analyses were used to identify predictors of caregiver-patient discrepancies. Results Caregivers consistently reported significantly higher levels of suffering and lower levels of quality of life than patients. Caregiver psychological well-being and health status accounted for a substantial portion of the difference in caregiver and patient ratings in both cross-sectional and longitudinal analyses. Caregiver depression and burden were consistently positively associated with the magnitude of caregiver-patient discrepancy, and caregiver health status was negatively associated with the size of the discrepancy. Conclusions Caregiver assessments of dementia patients may determine the type and frequency of treatment received by the patient, and caregivers’ ability to reliably detect change in patient status can play a critical role in evaluating the efficacy of therapeutic interventions and pharmacologic agents. Clinicians and researchers working with dementia patients who rely on caregiver reports of patient status should be sensitive to the health and well-being of the caregiver and recognize that caregiver assessments may be negatively biased when the caregiver’s own well-being is compromised.

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Proxy Reporting in Five Areas of Functional Status: Comparison with Self-Reports and Observations of Performance

Cited by 199 publications

References 52 publications

Proxy ratings of patient quality of life Factors related to patient–proxy agreement

Proxy ratings of patient quality of life Factors related to patient–proxy agreement

Ability to Walk 1/4 Mile Predicts Subsequent Disability, Mortality, and Health Care Costs

Magnitude and Causes of Bias Among Family Caregivers Rating Alzheimer Disease Patients

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