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Quality of Life Research
Gepubliceerd in: Quality of Life Research 11/2015

03-06-2015

A new perspective on proxy report: Investigating implicit processes of understanding through patient–proxy congruence

Auteurs: Carolyn E. Schwartz, Armon Ayandeh, Jonathan D. Rodgers, Paul Duberstein, Bianca Weinstock-Guttman, Ralph H. B. Benedict

Gepubliceerd in: Quality of Life Research | Uitgave 11/2015

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Abstract

Background

Utilizing proxy report is a common solution to gathering quality-of-life information from people who are not capable of reliably answering questionnaires, such as people with dementia. Proxy report could, however, also provide information about patients’ implicit processes of understanding, which we define as automatic, schema-driven cognitive processes that allow one to have a better understanding of oneself and of one’s body, make oneself known and knowable to members of the social network, and allow one to react proactively in response to cues. We investigated whether implicit processes of understanding explain some of the association between reserve and healthy lifestyle behaviors.

Methods

We operationalized three implicit processes of understanding: (a) psychosocial understanding; (b) insight into physical disability; and (c) somatic awareness. This secondary analysis involved a cohort of multiple sclerosis patients and their caregiver informants (n = 118 pairs). Measures included a neurologist-administered Expanded Disability Status Scale, patient- and informant-completed survey measures, and a heartbeat perception test (interoception). Patient–other congruence assessed implicit processes of understanding: psychosocial understanding (neurocognitive and personality); physical-disability insight; and somatic awareness (interoception).

Results

Effect sizes (ES) for the inter-correlations between the three implicit processes were small. Psychosocial understanding was associated with higher past reserve-building activities (small ES). Psychosocial understanding explained variance in healthy lifestyle behaviors over and above the variance explained by current reserve-building activities (∆R 2 = 0.04; model R Adjusted 2  = 0.18).

Conclusions

Proxy versus patient report can provide information about underlying interpretational processes related to insight. These processes are distinct from reserve, predict health outcomes, and can inform lifestyle-changing interventions.
vorige artikel Evaluation of the stages of completion and scoring of the Patient Generated Index (PGI) in patients with rheumatic diseases
volgende artikel Validation of the Community Integration Questionnaire in the adult burn injury population
Bijlagen
Alleen toegankelijk voor geautoriseerde gebruikers
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Metagegevens
Titel
A new perspective on proxy report: Investigating implicit processes of understanding through patient–proxy congruence
Auteurs
Carolyn E. Schwartz
Armon Ayandeh
Jonathan D. Rodgers
Paul Duberstein
Bianca Weinstock-Guttman
Ralph H. B. Benedict
Publicatiedatum
03-06-2015
Uitgeverij
Springer International Publishing
Gepubliceerd in
Quality of Life Research / Uitgave 11/2015
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-015-1017-4

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