Article

OBJECTIVE: To estimate the extent of agreement between health professionals'
(ClinRO) and patients' (PRO) ratings on disabilities associated with breast
cancer (impairments, activity limitations and participation restrictions).
DESIGN: Cross-sectional. METHODS: Health care professionals measured arm
impairments, activity limitations and participation restrictions with the
international classification of functioning (ICF) breast cancer core set.
Participants filled five outcomes measures targeting health aspects of QOL that
were previously mapped to the ICF. Agreement between ClinRO and PRO was estimated
with quadratic Kappa. RESULTS: About 245 paired clinician and participant
completed the outcomes measures. A total of 60 items mapped to 24 different ICF
breast cancer core set codes, which provide 68 analyses for agreement. Impairment
was better addressed with PROs (mostly poor and fair level of agreement);
Activity limitations, both PROs and self-reported outcomes (SRO) (fair);
participation restrictions, PROs (fair). CONCLUSION: Clinicians usually
underestimate the symptoms and impairments of the patients, leading to a greater
proportion of poor agreement. PRO's provide valuable information on impairments
at the mental function level and pain. ClinRO's provide more valuable information
on physically assessed impairments (oedema). Activity limitations and
participation restrictions, excluding reporting the difficulty aspect of various
life situations, can be either SRO or ObsRO. Implications for rehabilitation
Impairments, activity limitation and participation restrictions are common
sequelae of breast cancer treatment, which ultimately may affect the person's
quality of life and should be investigated early on in the continuum of care.
Clinicians should rely on the symptoms' reported by the patient regarding
lymphedema and should identify the presence and severity of it. Patients inform
best on the severity of pain, fatigue and mental distress experienced during and
post-breast cancer treatment as clinicians tend to underestimate them. Clinicians
and patients concur on presence and severity of activity limitations but not on
difficulty, which can only be assessed from the patient's perspective.

Langue : ANGLAIS