Conference Proceedings - School of Nursing & Midwifery - Trinity ...

School of Nursing & Midwifery, Trinity College Dublin: 8 th Annual Interdisciplinary Research Conference
Transforming Healthcare Through Research, Education & Technology: 7 th – 9 th November 2007
Conference Proceedings
Section 2: Daily Diary Cards
One of the secondary objectives of this study was to explore the
patients’ experience of completing the daily diary cards, as well as
obtaining a greater understanding of the patterns of nausea and
vomiting they experienced as they progressed through their
chemotherapy treatment. Compliance among the patients
completing the DDCs in this study varied. Although most of them
completed all the sections of the diary card, only three out of the
ten patients that I interviewed actually completed them as they
were instructed. Therefore, it is difficult to ascertain how many of
the other remaining twenty-one patients completed them as
instructed. It was assumed that the patients would complete them
themselves on a daily basis. However, it is quite likely that in some
cases discussion with their spouse or some other persons may have
influenced the responses given. It is also possible that these other
people may have assisted or indeed in some instances completed
the DDCs. The impact of this remains unknown.
Compliance has frequently been found to be a problem in quality of
life assessments (Baum et al 1979). In a study conducted by
Verschelden et al (1996) on the compliance with, and accuracy of,
daily self-assessment of peak expiratory flows in asthma patients
over a three month period, they concluded that compliance was
generally poor and that a substantial percentage of the values were
invented. This concurs with the findings in this study as the
information recorded on the DDCs of the ten patients who were
interviewed did not match with what they described at interview.
Fayers (1995) suggests that to improve compliance, clinicians and
nurses should encourage patients to complete the cards and then
discuss with them what they have recorded. He suggests that
clinicians should use the DDCs as a convenient method of capturing
information about how the patient has been feeling since last
attending the hospital. This may improve compliance but it is not
always feasible for a health care professional to do so due to time
constraints or lack of trained staff in a busy clinic.
de Haes et al (1996) suggest that the compliance of patients,
especially when ill, will be enhanced if an instrument is short and
easy to complete. However, as seen in completing this study, the
length and ease of the instrument used does not appear to matter,
as all ten patients interviewed said that the DDCs was easy to
complete and well presented, yet most of them were completed in a
rather haphazard way.
It is difficult to know which patients in any study or clinical setting
will comply with completing data as requested by the research or
clinical teams and their lack of compliance can lead to serious
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