Measurement of quality of life using EQ-5D in patients on prolonged mechanical ventilation: comparison of patients, family caregivers, and nurses
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This study reports how QOL (quality of life) assessments differ between patients on prolonged mechanical ventilation (PMV) and their proxies (family caregivers and nurses).
We enrolled consecutive subjects on PMV for more than 21 days from five institutions. We conducted QOL assessments using the Taiwanese version of the EQ-5D in face-to-face interviews. Direct caregivers (family members and nurses) also completed the EQ-5D from the patient’s point of view.
For 55 of the 142 enrolled patients who were able to assess their QOL, we recruited 44 patient–family caregiver pairs, 53 patient–nurse pairs, and 42 family caregiver–nurse pairs. There were 81 family caregiver–nurse pairs out of 87 patients with poor cognition. The agreement between patient–family caregiver pairs was generally higher than that of patient–nurse pairs. As the proportions of exact agreement between family caregivers and nurses for patients with poor cognition were 98–99% for observable dimensions of mobility, self-care, and usual activities, they lead to a minimal difference in the final values.
QOL assessments from family caregivers agreed more closely with patients than did those from nurses using EQ-5D evaluations for patients with clear cognition, but either proxy was acceptable for rating PMV patients with poor cognition.
KeywordsProlonged mechanical ventilation Proxy Quality of life EQ-5D Utility
Prolonged mechanical ventilation
Quality of life
Intensive care unit
Respiratory care center
Respiratory care ward
Institutional review board
Mini-mental status examination
Intra-class correlation coefficient
This work was partially supported by grants from the National Health Research Institute (NHRI, Grant 97A1-HDPP01-014 and 98A1-PHAPHD-014), Chia-Yi Christian Hospital (CYCH, Grant R98-3), and the National Science Council (NSC, Grant 98-2341-B-002-129) in Taiwan. The authors also thank the members of the respiratory care ward of Chia-Yi Hospital, the Department of Health, Executive Yuan, Taiwan; the private Chen Ren-Der Hospital; Yang Ming Hospital (Chia-Yi); and the National Taiwan University Hospital for helping us to recruit study subjects.
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