Universität zu Köln

Simon, Steffen T., Altfelder, Nadine, Alt-Epping, Bernd, Bausewein, Claudia ORCID: 0000-0002-0958-3041, Weingaertner, Vera, Voltz, Raymond, Ostgathe, Christoph ORCID: 0000-0003-4449-5036, Radbruch, Lukas, Lindena, Gabriele and Nauck, Friedemann (2014). Is breathlessness what the professional says it is? Analysis of patient and professionals' assessments from a German nationwide register. Support. Care Cancer, 22 (7). S. 1825 - 1833. NEW YORK: SPRINGER. ISSN 1433-7339

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Abstract

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. 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 (kappa) was used to estimate the 'level of agreement' (LoA). 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 (kappa = 0.62) for the evaluation of presence of breathlessness and moderate (kappa = 0.5) for the estimation of severity. The proportion of over- or underestimated scores was similar. 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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Simon, Steffen T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Altfelder, Nadine UNSPECIFIED UNSPECIFIED UNSPECIFIED Alt-Epping, Bernd UNSPECIFIED UNSPECIFIED UNSPECIFIED Bausewein, Claudia UNSPECIFIED orcid.org/0000-0002-0958-3041 UNSPECIFIED Weingaertner, Vera UNSPECIFIED UNSPECIFIED UNSPECIFIED Voltz, Raymond UNSPECIFIED UNSPECIFIED UNSPECIFIED Ostgathe, Christoph UNSPECIFIED orcid.org/0000-0003-4449-5036 UNSPECIFIED Radbruch, Lukas UNSPECIFIED UNSPECIFIED UNSPECIFIED Lindena, Gabriele UNSPECIFIED UNSPECIFIED UNSPECIFIED Nauck, Friedemann UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-435094
DOI:	10.1007/s00520-014-2131-5
Journal or Publication Title:	Support. Care Cancer
Volume:	22
Number:	7
Page Range:	S. 1825 - 1833
Date:	2014
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1433-7339
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ADVANCED CANCER-PATIENTS; MINIMAL DOCUMENTATION SYSTEM; PALLIATIVE CARE; REPRESENTATIVE SURVEY; MEDICAL-RECORD; SYMPTOM; DYSPNEA; RECOGNITION; VALIDATION; MANAGEMENT Multiple languages Oncology; Health Care Sciences & Services; Rehabilitation Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/43509