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The present study examines differences, associations and agreement in cancer patients' and their nurses' ratings of cancer patients' coping resources, emotional distress and quality of life. The study sample includes 90 individual patient-nurse pairs. The patient and nurse in each pair independently completed the Cancer Behaviour Inventory, the Hospital Anxiety and Depression Scale and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being. The results indicate a distinct pattern in which nurses overestimate patients' emotional distress and underestimate patients' coping resources and quality of life. A nurse who overestimated a patient's emotional distress and underestimated his/her resources for handling the situation was also likely to underestimate the patient's quality of life. Patient-nurse pairs who demonstrated consistent agreement differed from remaining pairs in that they had a larger percentage of nurses with advanced education and previous responsibility for their patients' care and in that they had higher frequencies of patients who had previously received care at the ward > , 5 days. Nurses caring for patients with cancer should be aware of the risk of making systematic misjudgements of patients' status. Increased attention to patients' internal resources may improve nurses' ability to make correct assessments and plan for individualized care.

PURPOSE/OBJECTIVES: To investigate nurses' planning and implementation of individualized patient care in relation to patients' emotional distress as assessed by nurses and whether nurses and patients perceived the implemented care in a similar manner. DESIGN: Prospective, comparative. SETTING: Five oncologic-hematologic wards in Sweden. SAMPLE: 90 individual nurse-patient pairs were recruited and 81 were intact after three consecutive days. Each pair consisted of a patient with cancer and a nurse responsible for that patient's care. METHODS: Nurse-patient pairs were followed using questionnaires. Outcome measures were nurses' identification of patients' emotional distress, care planning, and nurse-patient ratings of implemented care. MAIN RESEARCH VARIABLES: Patients' emotional distress and nurses' implemented care. FINDINGS: Nurses identified a variety of emotional issues among patients and planned individual nursing interventions. Nurse and patient perceptions of implemented care demonstrated weak correlations for individually planned interventions and nurses' general caring behavior. With one exception, nurse self-reports did not indicate any differences in nurses' caring behavior directed to more and less distressed patients. Nurses reported providing comfort more frequently to patients with high levels of emotional distress, but this was not substantiated in patients' ratings. CONCLUSIONS: Nurses showed an intention to provide individualized care. However, with one exception, nurses did not report providing more care to patients with cancer with high levels of emotional distress than to less distressed patients. IMPLICATIONS FOR NURSING: To ensure individualized care, nurses in cancer care should closely validate the accuracy of their interpretation of patients' needs and their planning of care in collaboration with the patients.

The main aim of the present study was to investigate whether patient-nurse dis/agreement concerning cancer patients' situation was of importance to patients' satisfaction with care. Another aim was to describe cancer patients' satisfaction with care and to investigate its relationship to cancer patients' emotional distress. A consecutive sample of individual patient-nurse pairs (n = 82) was recruited and followed during 3 days. Each pair consisted of a cancer patient newly admitted to an oncological/haematological ward and a nurse responsible for that patient's care. The known phenomenon of nurse overestimation of cancer patients' problems did not appear to be of importance to patients' satisfaction with care. However, patients whose depressive problems were underestimated by nurses were significantly less satisfied with the care they received. Furthermore, anxious and depressed patients were less satisfied with some aspects of the care they received than were the remaining patients. Although the patients' ratings and experiences of received care indicated a high degree of satisfaction, the patients also expressed negative experiences of care. To improve the quality of cancer care, nurses need to improve their ability to identify cancer patients' emotional distress if they are to satisfy patients' needs.

Aim.: This paper is a report of a study of situational (nurse-patient agreement), personal and occupational factors of potential importance to oncology nurses' satisfaction with care provided and general work satisfaction. Background.: Nurses have a general tendency to attribute to patients with cancer more problems and suffering than patients themselves report. However, little is known about whether dis/agreement between oncology nurses and patients with cancer concerning perceptions of patients' situation is of importance to nurses' satisfaction with their work. Methods.: The study had a comparative and prospective design. Data were collected in 2005 using self-administrated questionnaires with 81 consecutively recruited nurse-patient pairs. Data were analysed with non-parametric tests (for comparison between subgroups) and with multiple regression analyses (for identifying predictors). Results.: Initial nurse-patient agreement concerning patients' emotional distress, coping resources and quality of life did not appear to be important to nurses' subsequent satisfaction with the care directed at a specific patient. However, higher satisfaction with care provided as well as general work satisfaction was reported by nurses with more experience of cancer care and with a lower workload. Conclusion.: To improve oncology nurses' opportunities to provide high quality cancer care, novice nurses and advanced beginners in particular should receive support and nurses' working conditions must be improved. Further research is needed to examine whether there are other aspects of the nurse-patient relationship that contribute to oncology nurses' satisfaction with the care provided to specific patients.