Are Family Proxies a Valid Source of Information About Cancer Patients' Quality of Life at the End-of-Life? A Literature Review

Abstract

AbstractIn patients with advanced cancer, the achievement of a peaceful death through palliative care is highly desired. The preservation of quality of life (QOL) is a primary goal of palliative treatments; measures of QOL thus serve as important indicators of the treatment efficacy. Patient ratings have traditionally been viewed as the gold standard for QOL measures because the physical and emotional symptoms that influence QOL are subjective phenomena. However, the palliative patient group may experience difficulties with symptom self-report. This raises serious issues in clinical trials concerning non-response bias and generalizability of the data. To address the non-response issue, proxy informants are often elicited to act as surrogate respondents for patients with advanced disease. However, satisfactory levels of agreement between patient and proxy QOL appraisals must be demonstrated before caregivers (i.e., family members and close friends) can be deemed reliable sources of QOL assessments. This re...