Patient-Family Caregiver Concordance of Symptom Assessment for Esophageal Cancer Patients Undergoing Esophagectomy

Background Esophageal cancer patients suffer from multiple and severe symptoms during the postoperative recovery period. Family caregivers play a vital role in assisting patients to cope with their symptoms. Objective To examine the concordance of esophageal cancer patients and their caregivers on assessing patients symptoms after surgery and identify predictors associated with the symptom concordance. Methods In this cross-sectional study, 213 patient-caregiver dyads completed general information questionnaires, the Memorial Symptom Assessment Scale, the Depression Subscale of Hospital Anxiety and Depression Scale, the Mutuality Scale, and the Zarit Burden Interview (for caregivers). Data were analyzed using intraclass correlation coefficients, paired t tests, and binary logistic regression. Results At the dyad level, agreement of patients and caregivers reported symptoms ranged from poor to fair. At the group level, patients reported significantly higher scores than caregivers in most symptoms. Of the 213 dyads, 119 (55.9%) were identified as concordant on symptom assessment. Patients nasogastric tube, perceived mutuality, caregivers educational background, and dyads communication frequency with each other could predict their concordance of symptom assessment. Conclusions There were relatively low agreements between esophageal cancer patients and caregivers on assessing patients symptoms, and caregivers tended to underestimate patients symptoms. The dyads symptom concordance was influenced by patient-, caregiver-, and dyad-related factors. Implications for Practice Having an awareness of the incongruence on assessing symptoms between esophageal cancer patients and caregivers may help healthcare professionals to comprehensively interpret patients symptoms and develop targeted dyadic interventions to improve their concordance, contributing to optimal symptom management and health outcomes.