A comparison of perceptions of cancer patients and significant key others of patients' quality of life and symptom distress

A two-group, nonexperimental descriptive survey was conducted to determine if there were differences in perceptions between the cancer patients and their significant key others (SKO's) perceptions of the patients' Quality of Life (QOL) and Symptom Distress (SD). The incongruency of perceptions has been attributed to the patients use of the coping mechanism of downward shifting. When faced with a threatening condition such as cancer, patients compare themselves to less fortunate others and self-enhance their condition and underestimate their symptoms as a means of coping and reducing stress. According to King's model of human transaction using a coping mechanism potentially affects the congruency of perceptions necessary for goal attainment.

A convenience sample of 70 cancer patients and their designated SKOs were sampled at 7 treatment sites. The Quality of Life-Cancer Version (QLI-CV) and the Symptom Distress Scale (SDS) were used to collect data.

A Wilcoxon matched-pairs signed ranks test was used to analyze the QLI-CV total and 4 subscale scores and the SDS total scores. There was no significant difference in the responses of the QLI-CV total or subscale scores. There was a significant difference between the patients and SKO groups on the SDS (z = 2.76, p =.0058). Sixty percent of the SKO group overestimated the amount of symptom distress experienced by patients. The change in the patients' perceptions produced significant differences between the patients and SKOs groups. Demographically, Protestantism, lower education levels, and lower income were related to the differences in perceptions.