A comprehensive assessment of satisfaction with care: preliminary psychometric analysis in an oncology institute in Italy

BACKGROUND

Little is known about patients' perception of the quality of the care they receive in oncology hospitals. We developed a 61-item comprehensive assessment of satisfaction with care (CASC) to evaluate the competence of hospital physicians and nurses, as well as aspects of care organisation and hospital environment. The aims of this study were to define the structure of the CASC and assess the internal consistency and convergent and discriminant validity of its scales.

PATIENTS AND METHODS

Three hundred ninety-five consecutive cancer patients discharged from an oncology institute in Italy were asked to complete the CASC at home and return it in a self-addressed envelope.

RESULTS

Two percent of the patients refused to participate and 25% failed to return the questionnaire. Separate factor analyses of the CASC sub-scales disclosed the perceived extent of doctors' and nurses' availability, coordination, human quality, technical competence, provision of psychosocial care and information, as well as the patients' general satisfaction, perception of the organisation of their care, access and comfort. Multi-trait scaling analysis was carried out on item-grouping resulting from factor analyses. High levels of internal consistency and convergent validity were obtained but discriminant validity could be improved.

CONCLUSIONS

Results of present psychometric testing of the CASC forecast adequate properties. This will be confirmed by repeating these analyses in a cross-cultural setting.

A comprehensive assessment of satisfaction with care for cancer patients

The present paper reports on the initial development of a comprehensive questionnaire for assessing cancer patients' perception of the quality of care received in the oncology hospital. This questionnaire is primarily intended to evaluate interventions aimed at improving quality of life and focuses on patients' interactions with doctors and nurses. The current questionnaire includes 61 items assessing doctors' and nurses' technical competence, communication skills, interpersonal qualities, and availability; aspects of the hospital environment and treatment planning; and general satisfaction. Most items refer to an aspect of care rated on a five-point Likert scale from "Poor" to "Excellent". Additionally, each aspect of care is also evaluated by a dichotomous (yes/no) question on the patient's wish (or not) for its improvement. This questionnaire is the result of consecutive pilot tests (from April 1994 to September 1995). Analysis of patients' comments, items that patients omitted to respond to and score distributions have identified items needing to be rephrased, reworded, eliminated or placed in specific sections. Items showing low scores or acceptable score distributions have been stressed as appropriate for inclusion in the final questionnaire version.

Psycho-social aspects of breast cancer susceptibility testing: a literature review

An important demand for breast cancer susceptibility (BRCA) testing is anticipated not only in women at high risk of breast cancer but also in the general population. However, the benefits of this new technology may be substantially counterbalanced by the risks and limitations associated with it. BRCA testing offers the potential for early detection of breast cancer; however, it may lead to psycho-socially harmful consequences. Both carriers and non-carriers of a BRCA mutation may face tremendous emotional upheaval which may adversely impact on subsequent attitudes towards health care. This paper points to the need for empirical studies examining the psycho-social aspects of BRCA testing. These studies should be undertaken cross-culturally in order to take into account the variations due to different health care systems and cultural background on psycho-social correlates of cancer genetic testing.

Professional rehabilitation of lymphoma patients: a study of psychosocial factors associated with return to work

During the last ten years a substantial reduction in mortality has been obtained for Hodgkin's and non-Hodgkin's lymphoma. Since lymphoma treatment is often accompanied by side effects and long-term sequelae, however, patients often have problems with rehabilitation. It is thus very important that these problems and needs be identified. Going back to work is one of the main objectives of rehabilitation and can be taken as a valuable indicator of the problems and needs of such patients. We therefore conducted a study at the Jules Bordet Institute between December 1989 and December 1990. Of the patients in remission and able to go back to work, only 54% of them have done so. Anxiety, depression, and treatment toxicity interfere with return to work, and the likelihood of job reentry increases with the time lapse since the end of treatment. Rehabilitation programs must focus on alleviating illness and treatment sequelae as soon as treatment ends.