Patient, family, nurse perspectives on Chinese elders' quality of life

Background Families and nurses are important care-providers and proxies of older people. Their ability to assess the quality of life of elders in ways that align with how older people assess themselves has policy implications for allocating services and resources to older persons. Aim To investigate the alignment of perspectives of the quality of life held by older people, their families and nurses in China. Methods Employing a survey design using concurrent EQ-5D-3L and WHOQOL-BREF surveys, responses from 72 matched stakeholder groups were compared and agreement tested using weighted kappa/one-way random intra-class correlations and paired Student's t-test. Results On the more observable dimensions families and nurses were in close agreement with the older person in relation to quality of life reports. However, in the more subjective domains, family and especially nurses tended to estimate that the older person's suffering as more severe than they themselves thought. Conclusion The perspectives of older patients and their family are more closely aligned regarding the older person's quality of life than that of nurses caring for them, a finding inconsistent with international research. Implication for nursing and health policy The evidence suggests that nursing work assignment processes could influence the accuracy of nurses' perceptions of their patient's quality of life.