Health care providers underestimate symptom intensities of cancer patients: A multicenter European study

Laugsand, Eivor A; Sprangers, Mirjam AG; Bjordal, Kristin; Skorpen, Frank; Kaasa, Stein; Klepstad, Pål

doi:10.1186/1477-7525-8-104

Health and Quality of Life Outcomes

Table 5 Factors associated with agreement across all pairs of symptom observations (N = 21263)^a

From: Health care providers underestimate symptom intensities of cancer patients: A multicenter European study

Factors possibly affecting agreement		Health care provider underestimation		Good agreement		Health care provider overestimation		Chi-square
		Number	%	Number	%	Number	%
Age	≤ 60	1013	10.9	8122	87.7	126	1.4	0.629
	> 60	1268	10.7	10410	88.0	146	1.2
Body Mass Index	< 25	1378	10.3	11855	88.5	169	1.3	0.583
	≥ 25	693	9.8	6274	88.9	89	1.3
KPS ^b	< 80	1808	11.1	14110	86.8	347	2.1	0.032
	≥ 80	474	9.9	4240	88.2	94	2.0
Mini Mental State, total score	≤ 23	265	9.5	2455	87.6	81	2.9	< 0.001
	> 23	1927	11.3	14806	86.7	340	2.0
Time since diagnosis (months)	≤ 3	550	12.5	3797	86.5	43	1.0	< 0.001
	> 3	1420	9.6	13162	89.0	204	1.4
Gender	Female	1122	11.1	8812	87.5	136	1.4	0.261
	Male	1161	10.5	9727	88.2	136	1.2
Department	Hospitalized patients	1992	12.1	14314	86.7	201	1.2	< 0.001
	Out-patients	291	6.3	4225	92.1	71	1.5
Status of opioid treatment	Recently initiated	593	15.4	3219	83.5	43	1.1	< 0.001
	Stable dosing	1679	9.8	15159	88.6	228	1.3
Previous or ongoing abuse alcohol	Yes	113	9.8	1017	88.5	19	1.7	0.304
	No	2161	10.9	17477	87.9	252	1.3
Previous or ongoing abuse drugs	Yes	19	9.2	180	87.4	7	3.4	0.024
	No	2250	10.8	18283	87.9	267	1.3
Chemotherapy the past 24 hours	Yes	331	10.4	2833	88.6	32	1.0	0.180
	No	1952	10.9	15706	87.8	240	1.3
Profession of health care provider ^c	Physician	859	10.6	6970	86.2	261	3.2	< 0.001
	Nurse	1090	10.0	9573	88.1	208	1.9
Metastases	None	406	11.2	3176	87.7	39	1.1	0.430
	One or more	1917	11.0	15352	87.7	233	1.3
Cancer diagnosis	Breast	292	10.0	2609	89.0	31	1.1	< 0.001
	Female reproductive organs	183	11.5	1383	87.2	20	1.3
	Gastrointestinal	455	9.4	4306	89.4	58	1.2
	Haematological	142	11.5	1077	87.3	14	1.1
	Head and neck	148	12.8	983	85.3	21	1.8
	Lung	481	12.8	3241	86.0	46	1.2
	Other	198	10.8	1607	87.6	29	1.6
	Prostate	237	9.4	2233	89.0	40	1.6
	Unknown origin	53	9.6	491	89.3	6	1.1
	Urological	171	11.4	1317	87.5	18	1.2
Country	Denmark	3	0.9	304	95.3	11	3.5	< 0.001
	Finland	25	7.7	295	90.8	5	1.5
	Germany	662	22.4	2231	75.5	61	2.1
	Greece	5	9.3	48	88.9	1	1.9
	Iceland	105	6.6	1437	90.3	49	3.1
	Italy	137	3.1	4196	96.1	34	0.8
	Lithuania	44	7.5	533	90.5	12	2.0
	Norway	546	10.5	4578	88.4	54	1.0
	Sweden	182	14.0	1107	85.3	9	0.7
	Switzerland	281	22.8	937	76.1	13	1.1
	United Kingdom	293	9.2	2874	89.8	33	1.0

^aNumber of paired symptom observations. Across one pair of raters and 11 questions for 1933 patients (1 × 11 × 1933 = 21263) (varies due to missing data).
^bKarnofsky performance status
^cFor 204 patients, the profession of the health care provider was not reported.

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ISSN: 1477-7525

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