Depression assessment: Spouses are poor proxies for cardiovascular disease patients

Background: Patients are frequently assisted by proxies, usually a spouse, to complete health and medical surveys, including depression assessments. Objective: The objective of this study was to examine whether spousal assessments of patient depression concord with those of the patient. Materials an...

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Main Authors: Samia R Toukhsati, Lewis Yau, Rosemary Yates, Isabelle Catrice, Cory Wasser, Lynette Young, Kimberley Greening, Gabriella Flaks, Jenna Miller, David L Hare
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2017-01-01
Series:Heart and Mind
Subjects:
Online Access:http://www.heartmindjournal.org/article.asp?issn=2468-6476;year=2017;volume=1;issue=3;spage=102;epage=106;aulast=Toukhsati
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author Samia R Toukhsati
Lewis Yau
Rosemary Yates
Isabelle Catrice
Cory Wasser
Lynette Young
Kimberley Greening
Gabriella Flaks
Jenna Miller
David L Hare
author_facet Samia R Toukhsati
Lewis Yau
Rosemary Yates
Isabelle Catrice
Cory Wasser
Lynette Young
Kimberley Greening
Gabriella Flaks
Jenna Miller
David L Hare
author_sort Samia R Toukhsati
collection DOAJ
description Background: Patients are frequently assisted by proxies, usually a spouse, to complete health and medical surveys, including depression assessments. Objective: The objective of this study was to examine whether spousal assessments of patient depression concord with those of the patient. Materials and Methods: Consecutive adult cardiac patients attending an outpatient cardiovascular disease clinic accompanied by an adult were enrolled. Patient–spousal pairs independently completed the Cardiac Depression Scale (CDS) on behalf of the patient. Proxies provided demographic and medical history information and also completed the Physical Health Questionnaire. Results: A total of 72 patients (males 75%; mean age = 67.18 ± 11.35 years) and 72 spouses (mean age = 65.19 ± 11.49 years) met enrollment and analysis criteria. Most spouses were female (75%). Proxies rated patients significantly higher on the CDS (mean = 93.14 ± 29.33) than did patients of themselves (mean = 87.93 ± 26.79), t(71) = –2.05, P < 0.05. Patient–spousal concordance was low to moderate on the total CDS (concordance correlation coefficient [CCC] = 0.69) and CDS symptoms including mood (CCC = 0.35), anhedonia (CCC = 0.63), anxiety (CCC = 0.71), irritability (CCC = 0.55), hopelessness (CCC = 0.50), cognitive dysfunction (CCC = 0.41), and sleep disturbance (CCC = 0.64). Conclusions: These results suggest that spouses have limited insight into patient's psychological status, as self-reported by patients. Proxy assessments should be interpreted with caution and, wherever possible, patients should be encouraged to complete depression assessments on their own.
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spelling doaj.art-96a953ba10a242c48369019f8d02e8d42022-12-21T21:27:53ZengWolters Kluwer Medknow PublicationsHeart and Mind2468-64762468-64842017-01-011310210610.4103/hm.hm_1_18Depression assessment: Spouses are poor proxies for cardiovascular disease patientsSamia R ToukhsatiLewis YauRosemary YatesIsabelle CatriceCory WasserLynette YoungKimberley GreeningGabriella FlaksJenna MillerDavid L HareBackground: Patients are frequently assisted by proxies, usually a spouse, to complete health and medical surveys, including depression assessments. Objective: The objective of this study was to examine whether spousal assessments of patient depression concord with those of the patient. Materials and Methods: Consecutive adult cardiac patients attending an outpatient cardiovascular disease clinic accompanied by an adult were enrolled. Patient–spousal pairs independently completed the Cardiac Depression Scale (CDS) on behalf of the patient. Proxies provided demographic and medical history information and also completed the Physical Health Questionnaire. Results: A total of 72 patients (males 75%; mean age = 67.18 ± 11.35 years) and 72 spouses (mean age = 65.19 ± 11.49 years) met enrollment and analysis criteria. Most spouses were female (75%). Proxies rated patients significantly higher on the CDS (mean = 93.14 ± 29.33) than did patients of themselves (mean = 87.93 ± 26.79), t(71) = –2.05, P < 0.05. Patient–spousal concordance was low to moderate on the total CDS (concordance correlation coefficient [CCC] = 0.69) and CDS symptoms including mood (CCC = 0.35), anhedonia (CCC = 0.63), anxiety (CCC = 0.71), irritability (CCC = 0.55), hopelessness (CCC = 0.50), cognitive dysfunction (CCC = 0.41), and sleep disturbance (CCC = 0.64). Conclusions: These results suggest that spouses have limited insight into patient's psychological status, as self-reported by patients. Proxy assessments should be interpreted with caution and, wherever possible, patients should be encouraged to complete depression assessments on their own.http://www.heartmindjournal.org/article.asp?issn=2468-6476;year=2017;volume=1;issue=3;spage=102;epage=106;aulast=Toukhsaticardiac depression scalecardiovascular diseaseconcordancedepressionpatientproxy
spellingShingle Samia R Toukhsati
Lewis Yau
Rosemary Yates
Isabelle Catrice
Cory Wasser
Lynette Young
Kimberley Greening
Gabriella Flaks
Jenna Miller
David L Hare
Depression assessment: Spouses are poor proxies for cardiovascular disease patients
Heart and Mind
cardiac depression scale
cardiovascular disease
concordance
depression
patient
proxy
title Depression assessment: Spouses are poor proxies for cardiovascular disease patients
title_full Depression assessment: Spouses are poor proxies for cardiovascular disease patients
title_fullStr Depression assessment: Spouses are poor proxies for cardiovascular disease patients
title_full_unstemmed Depression assessment: Spouses are poor proxies for cardiovascular disease patients
title_short Depression assessment: Spouses are poor proxies for cardiovascular disease patients
title_sort depression assessment spouses are poor proxies for cardiovascular disease patients
topic cardiac depression scale
cardiovascular disease
concordance
depression
patient
proxy
url http://www.heartmindjournal.org/article.asp?issn=2468-6476;year=2017;volume=1;issue=3;spage=102;epage=106;aulast=Toukhsati
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