PMID- 31438967
OWN - NLM
STAT- MEDLINE
DCOM- 20191111
LR  - 20200505
IS  - 1477-7525 (Electronic)
IS  - 1477-7525 (Linking)
VI  - 17
IP  - 1
DP  - 2019 Aug 22
TI  - A comparison of nurses' and physicians' perception of cancer treatment burden 
      based on reported adverse events.
PG  - 146
LID - 10.1186/s12955-019-1210-1 [doi]
LID - 146
AB  - BACKGROUND: Cancer treatments are associated with a multitude of adverse events 
      (AEs). While both nurses and physicians are involved in patient care delivery and 
      AE assessment, very few studies have examined the differences between nurses' and 
      physicians' reporting and perception of AEs. An approach was recently proposed to 
      assess treatment burden based on reported AEs from the physician's perspective. 
      In this paper, we use this approach to evaluate nurses' perception of burden, and 
      compare nurses' and physicians' assessment of the overall and relative burden of 
      AEs. METHODS: AE records for 334 cancer patients from a randomized clinical trial 
      conducted by the SWOG Cancer Research Network were evaluated by 14 nurses at 
      Columbia University Medical Center. Two nurses were randomly selected to assign a 
      burden score from 0 to 10 based on their impression of the global burden of the 
      captured AEs. These nurses did not interact directly with the patients. Scores 
      were compared to previously obtained physicians scores using paired T-test and 
      Kappa statistic. Severity scores for individual AEs were obtained using 
      mixed-effects models with nurses assessments, and were qualitatively compared to 
      physicians'. RESULTS: Given the same AEs, nurses' and physicians' perception of 
      the burden of AEs differed. While nurses generally perceived the overall burden 
      of AEs to be only slightly worse compared to physicians (mean average VAS score 
      of 5.44 versus 5.14), there was poor agreement in the perception of AEs that were 
      in mild to severe range. The percent agreement for a moderate or worse AE was 64% 
      with a Kappa of 0.34. Nurses also assigned higher severity scores to symptomatic 
      AEs compared to physicians (p < 0.05), such as gastrointestinal (4.77 versus 
      4.14), hemorrhage (5.07 versus 4.14), and pain (5.17 versus 4.14). CONCLUSIONS: 
      These differences in the perception of burden of AEs can lead to different 
      treatment decisions and symptom management strategies. Thus, having provider 
      consistency, training, or a collaborative approach in follow-up care between 
      nurses and physicians is important to ensure continuity in care delivery. 
      Moreover, estimating overall burden from both physicians' and nurses' 
      perspective, and comparing them may be useful for deciding when collaborations 
      are warranted.
FAU - Lee, Shing M
AU  - Lee SM
AUID- ORCID: 0000-0001-8413-6869
AD  - Department of Biostatistics, Mailman School of Public Health, Columbia 
      University, 722 W.168th Street, 6th Floor, New York, NY, 10032, USA. 
      sml2114@columbia.edu.
FAU - Miao, Jieling
AU  - Miao J
AD  - SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Research 
      Center, Seattle, WA, USA.
FAU - Wu, Ruby
AU  - Wu R
AD  - Department of Medicine, Herbert Irving Comprehensive Cancer Center, Columbia 
      University, New York, NY, USA.
FAU - Unger, Joseph M
AU  - Unger JM
AD  - SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Research 
      Center, Seattle, WA, USA.
FAU - Cheung, Ken
AU  - Cheung K
AD  - Department of Biostatistics, Mailman School of Public Health, Columbia 
      University, 722 W.168th Street, 6th Floor, New York, NY, 10032, USA.
FAU - Hershman, Dawn L
AU  - Hershman DL
AD  - Department of Medicine, Herbert Irving Comprehensive Cancer Center, Columbia 
      University, New York, NY, USA.
LA  - eng
GR  - UG1 CA189974/CA/NCI NIH HHS/United States
GR  - 1UG1CA189974-01/CA/NCI NIH HHS/United States
GR  - MRSG-13-146-01-CPHPS/American Cancer Society/
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20190822
PL  - England
TA  - Health Qual Life Outcomes
JT  - Health and quality of life outcomes
JID - 101153626
RN  - 0 (Antineoplastic Agents)
SB  - IM
MH  - Antineoplastic Agents/*adverse effects
MH  - *Attitude of Health Personnel
MH  - *Cost of Illness
MH  - Female
MH  - Humans
MH  - Male
MH  - Neoplasms/*drug therapy/psychology
MH  - Nursing Staff, Hospital/psychology
MH  - Physicians/psychology
MH  - *Quality of Life
PMC - PMC6704545
OTO - NOTNLM
OT  - Adverse event burden assessment
OT  - Perception of burden
OT  - Provider consistency
COIS- The authors declare that they have no competing interests.
EDAT- 2019/08/24 06:00
MHDA- 2019/11/12 06:00
PMCR- 2019/08/22
CRDT- 2019/08/24 06:00
PHST- 2019/04/15 00:00 [received]
PHST- 2019/08/06 00:00 [accepted]
PHST- 2019/08/24 06:00 [entrez]
PHST- 2019/08/24 06:00 [pubmed]
PHST- 2019/11/12 06:00 [medline]
PHST- 2019/08/22 00:00 [pmc-release]
AID - 10.1186/s12955-019-1210-1 [pii]
AID - 1210 [pii]
AID - 10.1186/s12955-019-1210-1 [doi]
PST - epublish
SO  - Health Qual Life Outcomes. 2019 Aug 22;17(1):146. doi: 10.1186/s12955-019-1210-1.