Good caring : Patient realities and staff perceptions

Abstract: Cancer patient and staff perceptions of the importance of caring behaviors were identifiedby the Caring Assessment Instrument (CARE-Q, forced and free response formats).Patients' emotional distress was investigated by the Hospital Anxiety and DepressionScale (HADS) and open ended questions. Patients stressed the importance of clinicalknow-how and information whereas staff stressed emotional aspects of caring and gavelow priority to the information aspect (Studies I-V). These discrepancies were unrelatedto differences in cognitive representations of the concept of caring (Studies I-III) and toresponse formats (Study II-III). A dyadic design in which staff answered for individualpatients resulted in similar discrepancies and associations between patient and staffperceptions as those demonstrated when staff answered for a "hypothetical patient"(Studies IV-V). Strong associations were identified between staff's own perceptions andtheir views of patient perceptions of the importance of caring behaviors (Study V).Patients and staff did not agree on individual patients' level of anxiety and depression(Studies IV), quality of life, health and/or greatest health-related concern (Study V). Staffjudgements of the importance of caring behaviors for an individual patient were notrelated to the patient's emotional state (Studie IV-V). It is concluded that staff are notoverly successful in judging the importance of caring behaviors and emotional states ofpatients. The results suggest that communication skills and methods for assessing patientneeds are insufficient. Staff should validate their perceptions against patient realities inorder to give patients good caring.