Agreement Between Patient and Proxy Responses of Health-Related Quality of Life After Hip Fracture
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OBJECTIVES: To examine agreement between patient and proxy respondents on health-related quality of life (HRQL) over time during the 6-month recovery after hip fracture. DESIGN: Prospective longitudinal cohort study. SETTING: A healthcare region serving Edmonton, Alberta, and the surrounding area. PARTICIPANTS: Two hundred forty-five patients aged 65 and older, were treated for hip fracture, and had Mini-Mental State Examination scores greater than 17; 245 family caregivers participated as proxy respondents. MEASUREMENTS: Primary outcome was HRQL (Health Utilities Mark 2 and Mark 3). Interviews were completed within 5 days after surgery and at 1, 3, and 6 months. Agreement was evaluated using intraclass correlation coefficients (ICCs). RESULTS: Agreement was considered moderate to excellent for HRQL. ICC values ranged from 0.50 to 0.85 (P<.001) for physically based observable dimensions of health status and from 0.32 to 0.66 (P<.01) for less-observable dimensions. Agreement improved with time. Time and the number of days between patient and proxy interviews were significant factors in accounting for patient-proxy differences. CONCLUSION: Although proxy and patient responses are not interchangeable, proxy responses provide an option for assessing function and health status in patients who are unable to respond on their own behalf.
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