Patient interpretation of the Patient-Generated Subjective Global Assessment (PG-SGA) Short Form

Abstract

Background:The Patient-Generated Subjective Global Assessment (PG-SGA) is a patient-reported instrument for assessment of nutrition status in patients with cancer. Despitethorough validation of PG-SGA, little has been reported about the way patients perceive,interpret, and respond to PG-SGA. The aim of this study was to investigate how patientsinterpret the patient-generated part of the PG-SGA, called PG-SGA Short Form.Methods:Purposive sampling was used to identify participants that had experienced weight lossand/or reduced dietary intake and/or had a low body mass index. Data were collected from 23patients by combining observations of patientsfilling in the PG-SGA Short Form, think-aloudtechnique and structured interviews, and analyzedqualitatively using systematic text condensation.Results:Most of the participants managed to complete the PG-SGA Short Form withoutproblems. However, participant-related and questionnaire-related sources of misinterpreta-tion were identified, possibly causing misinterpretations or wrong/missing answers.Participants either read too fast and skipped words, or they struggled tofind response optionsthat were suitable for covering their entire situation perfectly. The word“normal”wasperceived ambiguous, and the word“only”limited the participants’possibility to accuratelydescribe their food intake. Long recall periods in the questions and two-pieced responseoptions made it difficult for patients to select only one option.Conclusion:The results of this study provide a unique patient perspective of using the PG-SGA Short Form and valuable input for future use and revisions of the form. The identifiedsources of misunderstanding could be used to develop a standardized instruction manual forpatients and health care personnel using the PG-SGA Short Form.