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Fabian A, Rühle A, Domschikowski J, Trommer M, Wegen S, Becker JN, Wurschi G, Boeke S, Sonnhoff M, Fink CA, Käsmann L, Schneider M, Bockelmann E, Treppner M, Mehnert-Theuerkauf A, Nicolay NH, Krug D. Satisfaction with radiotherapy care among cancer patients treated in Germany-secondary analysis of a large multicenter study. Strahlenther Onkol 2024; 200:487-496. [PMID: 37975882 PMCID: PMC11111518 DOI: 10.1007/s00066-023-02176-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 10/22/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE Patient satisfaction with healthcare has been linked to clinical outcomes and regulatory agencies demand its regular assessment. Therefore, we aimed to investigate patient satisfaction with radiotherapy care and its determinants. METHODS This is a secondary analysis of a multicenter prospective cross-sectional study. Eligible cancer patients anonymously completed questionnaires at the end of a course of radiotherapy. The outcome variable was overall patient satisfaction with radiotherapy care measured with a 10-point Likert scaled single-item. Given patient satisfaction was defined for patients scoring ≥ 8 points. Determinants of given patient satisfaction were assessed by univariable and multivariable analyses. A p-value < 0.05 was considered statistically significant. RESULTS Out of 2341 eligible patients, 1075 participated (participation rate 46%). Data on patient satisfaction was provided by 1054 patients. There was a right-skewed distribution towards more patient satisfaction (mean = 8.8; SD = 1.68). Given patient satisfaction was reported by 85% (899/1054) of the patients. Univariable analyses revealed significant associations of lower patient satisfaction with tumor entity (rectal cancer), concomitant chemotherapy, inpatient care, treating center, lower income, higher costs, and lower quality of life. Rectal cancer as tumor entity, treating center, and higher quality of life remained significant determinants of patient satisfaction in a multivariable logistic regression. CONCLUSION Overall patient satisfaction with radiotherapy care was high across 11 centers in Germany. Determinants of patient satisfaction were tumor entity, treating center, and quality of life. Although these data are exploratory, they may inform other centers and future efforts to maintain high levels of patient satisfaction with radiotherapy care.
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Affiliation(s)
- Alexander Fabian
- Department of Radiation Oncology, University Hospital Schleswig-Holstein, Arnold-Heller-Str. 3, 24105, Kiel, Germany.
| | - Alexander Rühle
- Department of Radiation Oncology, Medical Center, Faculty of Medicine, University of Freiburg, 79106, Freiburg, Germany
- Department of Radiotherapy and Radiation Oncology, University Hospital Leipzig, 04103, Leipzig, Germany
| | - Justus Domschikowski
- Department of Radiation Oncology, University Hospital Schleswig-Holstein, Arnold-Heller-Str. 3, 24105, Kiel, Germany
| | - Maike Trommer
- Department of Radiation Oncology, Cyberknife and Radiotherapy, Faculty of Medicine and University Hospital Cologne, 50937, Cologne, Germany
- Center for Molecular Medicine Cologne, University of Cologne, 50931, Cologne, Germany
| | - Simone Wegen
- Department of Radiation Oncology, Cyberknife and Radiotherapy, Faculty of Medicine and University Hospital Cologne, 50937, Cologne, Germany
| | - Jan-Niklas Becker
- Department of Radiotherapy and Special Oncology, Medical School Hannover, 30625, Hannover, Germany
| | - Georg Wurschi
- Department of Radiotherapy and Radiation Oncology, Jena University Hospital, 07747, Jena, Germany
| | - Simon Boeke
- Department of Radiation Oncology, University Hospital Tübingen, 72076, Tübingen, Germany
| | - Mathias Sonnhoff
- Center for Radiotherapy and Radiation Oncology, 28239, Bremen, Germany
| | - Christoph A Fink
- Department of Radiation Oncology, University Hospital Heidelberg, 69120, Heidelberg, Germany
| | - Lukas Käsmann
- Department of Radiation Oncology, University Hospital, LMU Munich, 81377, Munich, Germany
- Member of the German Center for Lung Research (DZL), Comprehensive Pneumology Center Munich (CPC-M), 81377, Munich, Germany
- Partner Site Munich, German Cancer Consortium (DKTK), 81377, Munich, Germany
| | - Melanie Schneider
- Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307, Dresden, Germany
| | - Elodie Bockelmann
- Department of Radiotherapy and Radiation Oncology, University Hospital Hamburg-Eppendorf, 20251, Hamburg, Germany
| | - Martin Treppner
- Institute of Medical Biometry and Statistics, University Hospital Freiburg, 79106, Freiburg, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, 04103, Leipzig, Germany
| | - Nils H Nicolay
- Department of Radiotherapy and Radiation Oncology, University Hospital Leipzig, 04103, Leipzig, Germany
- Partner Site Leipzig, Cancer Center Central Germany, 04103, Leipzig, Germany
| | - David Krug
- Department of Radiation Oncology, University Hospital Schleswig-Holstein, Arnold-Heller-Str. 3, 24105, Kiel, Germany
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Ziegler E, Klein J, Kofahl C. Patient experiences and needs in cancer care- results from a nationwide cross-sectional study in Germany. BMC Health Serv Res 2024; 24:572. [PMID: 38698426 PMCID: PMC11067160 DOI: 10.1186/s12913-024-10951-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 04/04/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Patient-centredness has become a central quality indicator for oncology care. Elements include shared decision-making, patient navigation and integration of psychosocial care, which impact patient-reported and clinical outcomes. Despite efforts to promote patient-centred care in Germany in recent decades, implementation remains fragmented. Further, research on patient experiences with cancer care and its determinants is limited. Therefore, this study examines which patient- and facility-specific factors are associated with patient-centred quality care delivery. METHODS A cross-sectional study was conducted among 1,121 cancer patients in acute treatment, rehabilitation, and aftercare for different cancer entities across Germany. A participatory developed questionnaire was used. Outcome measures were the quality of physician-patient interaction and provision of psychosocial care during acute care. Predictors comprised patient-specific characteristics and treatment facility-specific factors. Multiple linear regression and multivariate binary logistic regression analyses were performed. In addition, a content analysis of open-ended comments on the patients' overall cancer care needs was applied. RESULTS Multiple linear regression analysis showed recent diagnosis (β=-0.12, p = < 0.001), being male (β=-0.11, p = 0.003), and having a preference for passive decision-making (β=-0.10, p = 0.001) to be significantly associated with higher interaction quality, but not age, education and health insurance type. An overall low impact of patient characteristics on interaction quality was revealed (adj. R2 = 0.03). Binary logistic regression analysis demonstrated the availability of central contact persons (OR = 3.10, p < 0.001) followed by recent diagnosis (p < 0.001), having breast cancer (p < 0.001) and being female (OR = 1.68, p < 0.05) to significantly predict offering psycho-oncological counselling to patients in acute care facilities. The availability of peer support visiting services (OR = 7.17, p < 0.001) and central contact persons (OR = 1.87, p < 0.001) in the care facility, breast cancer diagnosis (p < 0.001) and a higher level of education (p < 0.05) significantly increased the odds of patients receiving information about peer support in the treatment facility. Despite relatively satisfactory quality of physician-patient interactions in cancer care (M = 3.5 (± 1.1)), many patients expressed that better patient-centred communication and coordinated, comprehensive cancer care are needed. CONCLUSION The findings reflect effective developments and improvements in cancer care and suggest that patients' social characteristics are less decisive for delivering patient-centred quality care than systemic factors surrounding the care facilities. They can serve to inform oncology care in Germany.
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Affiliation(s)
- Elâ Ziegler
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Jens Klein
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Christopher Kofahl
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
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Arditi C, Eicher M, Junod J, Peytremann-Bridevaux I. Socio-demographic and health-related determinants of patients' overall rating and experiences of cancer care. BMC Cancer 2023; 23:918. [PMID: 37773108 PMCID: PMC10540394 DOI: 10.1186/s12885-023-11445-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 09/25/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Understanding how patient-reported experiences of care and overall rating of care vary among patients with different characteristics is useful to help interpret results from patient experience surveys and design targeted improvement interventions. The primary objective of this paper was to identify the socio-demographic and health-related characteristics independently associated with overall rating of cancer care. The secondary objective was to explore if and how these characteristics were associated with specific experiences of cancer care. METHODS This cross-sectional multicenter study analyzed self-reported data collected from 2696 patients diagnosed with breast, prostate, lung, colorectal, skin, or hematological cancer from four large hospitals in French-speaking Switzerland. Multivariate logistic regressions with purposeful stepwise selection of independent variables were used to identify the socio-demographic and health-related characteristics independently associated with overall rating of cancer care in the primary analyses. In the secondary analyses, we ran the multivariate model from the primary analyses with specific experiences of care as outcomes to estimate the adjusted odds ratios (OR) and 95% confidence intervals (CI) of the selected characteristics. RESULTS Respondents' mean rating of overall cancer care was 8.5 on a scale from 0 to 10, with 17% categorized as reporting a low rating (0-7 rating). Being a woman (OR 1.43, 95% CI 1.12-1.83), not being Swiss (OR 1.47, 95% CI 1.12-1.94), reporting lower health literacy (OR 1.95, 95% CI 1.54-2.47), preferring making medical decisions alone (OR 1.92, 95% CI 1.38-2.67), having forgone care due to cost (OR 1.72, 95% CI 1.29-2.29), having used complementary medicine (OR 1.55, 95% CI 1.22-1.97), and reporting poorer health (OR 3.12, 95% CI 2.17-4.50) were all independently associated with a low rating of overall cancer care. Poorer health, lower health literacy, and having forgone care were the three characteristics most often associated with problematic experiences of care. CONCLUSIONS Our results identified several patient characteristics consistently associated with lower overall rating of care and specific experiences of cancer care. Among these determinants, health literacy and financial hardship emerged as key recurring factors shaping poor patient experiences that should be prioritized for attention by cancer care services.
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Affiliation(s)
- Chantal Arditi
- Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.
| | - Manuela Eicher
- Institute of Higher Education and Research in Healthcare (IUFRS), Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Department of Oncology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Julien Junod
- Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Isabelle Peytremann-Bridevaux
- Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
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Kao MJ, Wang JY, Hu HY. Bidirectional referral system between National Taiwan University Hospital medical center and Zhongxiao Branch community hospital of Taipei City Hospital: focus on patient satisfaction. Sci Rep 2023; 13:14759. [PMID: 37679483 PMCID: PMC10484964 DOI: 10.1038/s41598-023-39794-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 07/31/2023] [Indexed: 09/09/2023] Open
Abstract
The policy of bidirectional referral between National Taiwan University Hospital and Taipei City Hospital has been launched due to the over-crowding of the emergency department at National Taiwan University Hospital. This research aims to evaluate patient satisfaction with the bidirectional referral. Sixty-six patients have been referred from the emergency department of National Taiwan University Hospital to Taipei City Hospital, Zhongxiao campus from April 2015 to December 2017. The selection criteria of the subjects for bidirectional referral include the management of patients classified as triage classification 2 or 3. Exclusion criteria are as follows: incomplete patient records and patients who chose hospice care. Sixty-six patients completed the questionnaires. Multivariate regression was used to evaluate the determinants of overall satisfaction scores of the bidirectional referral. The two overall satisfaction scores of patients were high (> 7). Three independent variables, (1) overall satisfaction scores of medical care at Taipei City Hospital, Zhongxiao campus, (2) waiting times for examination, treatment, and test, and (3) a positive question regarding quality improvement of delivered care for patients and family explained 69.3% adjusted variability of the overall satisfaction scores of bidirectional referrals. Therefore, the policy of bidirectional referrals and direct admission into the wards of Taipei City Hospital, Zhongxiao campus, from the emergency department of National Taiwan University Hospital met the criteria for patient satisfaction and public accountability.
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Affiliation(s)
- Mu-Jung Kao
- University of Taipei, Taipei City, Taiwan
- China Medical University, Taichung, Taiwan
- School of Medicine, National Yang-Ming Chiao Tung University, Hsinchu, Taiwan
| | - Jenn Yeu Wang
- Division of Nephrology and Division of Occupational Medicine, Department of Medicine, Taipei City Hospital, Zhongxiao Branch, No.87, Tongde Rd., Nangang Dist., Taipei City, 115006, Taiwan.
- University of Taipei, Taipei City, Taiwan.
- Taipei Medical University, Taipei City, Taiwan.
- School of Medicine, Fu Jen Catholic University, Taipei City, Taiwan.
- School of Medicine, National Yang-Ming Chiao Tung University, Hsinchu, Taiwan.
| | - Hsiao-Yun Hu
- University of Taipei, Taipei City, Taiwan
- School of Medicine, National Yang-Ming Chiao Tung University, Hsinchu, Taiwan
- Department of Education and Research, Taipei City Hospital, Taipei City, Taiwan
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Owais SS, Arnolda G, Lamprell K, Liauw W, Delaney GP, Olver I, Karnon J, Braithwaite J. Age-related experiences of colorectal cancer diagnosis: a secondary analysis of the English National Cancer Patient Experience Survey. BMJ Open Gastroenterol 2023; 10:bmjgast-2022-001066. [PMID: 36868584 PMCID: PMC9990662 DOI: 10.1136/bmjgast-2022-001066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 02/09/2023] [Indexed: 03/05/2023] Open
Abstract
OBJECTIVE The incidence of colorectal cancer (CRC) in people aged <50 years has been increasing dramatically in the past three decades and such patients are known to face difficulties in diagnosis. The objective of this study was to better understand the diagnostic experiences of patients with CRC and explore age-related differences in the proportion with positive experiences. METHOD A secondary analysis of the English National Cancer Patient Experience Survey (CPES) 2017 was conducted on the responses of patients with CRC, restricted to those likely to have been diagnosed in the preceding 12 months via pathways other than routine screening. Ten diagnosis-related experience questions were identified, with responses to them categorised as positive, negative or uninformative. Age group-related difference in positive experiences were described and ORs estimated, both raw and adjusted for selected characteristics. Sensitivity analysis was performed by weighting survey responses to 2017 cancer registrations by strata defined by age group, sex and cancer site, to assess whether differential response patterns by these characteristics affected the estimated proportion of positive experiences. RESULTS The reported experiences of 3889 patients with CRC were analysed. There was a significant linear trend (p<0.0001) for 9 of 10 experience items, with older patients consistently displaying higher rates of positive experiences and patients aged 55-64 showing rates of positive experience intermediate between younger and older age groups. This was unaffected by differences in patient characteristics or CPES response rates. CONCLUSION The highest rates of positive diagnosis-related experiences were reported by patients aged 65-74 or 75 years and older, and this is robust.
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Affiliation(s)
- Syeda Somyyah Owais
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Gaston Arnolda
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Klay Lamprell
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Winston Liauw
- St. George Cancer Care Centre, Saint George Hospital, Kogarah, New South Wales, Australia.,St. George Hospital Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Geoff P Delaney
- South-Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia.,Liverpool Hospital, South Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Ian Olver
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
| | - Jonathan Karnon
- Flinders Health and Medical Institute, Flinders University, Adelaide, South Australia, Australia
| | - Jeffrey Braithwaite
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
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Arditi C, Eicher M, Colomer‐Lahiguera S, Bienvenu C, Anchisi S, Betticher D, Dietrich P, Duchosal M, Peters S, Peytremann‐Bridevaux I. Patients' experiences with cancer care in Switzerland: Results of a multicentre cross-sectional survey. Eur J Cancer Care (Engl) 2022; 31:e13705. [PMID: 36130722 PMCID: PMC9787424 DOI: 10.1111/ecc.13705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 09/02/2022] [Accepted: 09/07/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVES The objectives were to describe patients' experiences of cancer care in Switzerland and explore the variation of these experiences by type of cancer. METHODS The Swiss Cancer Patient Experiences (SCAPE) study was a cross-sectional, multicentre survey conducted in 2018. Adult patients (n = 7145) with breast, prostate, lung, colorectal, skin or haematological cancer from four large hospitals in French-speaking Switzerland were invited to complete a survey. Logistic regressions were used to assess whether experiences varied according to cancer type, adjusting for confounders. RESULTS Of the 3121 persons who returned the survey (44% response rate), 2755 reporting an eligible cancer were included in the analyses. Participants' average score for overall care was 8.5 out of a maximum score of 10. Higher rates of positive experiences were found for nurse consultations (94%), diagnostic tests (85%) and inpatient care (82%). Lower positive responses were reported for support for people with cancer (70%), treatment decisions (66%), diagnosis (65%) and home care (55%). We observed non-systematic differences in experiences of care by cancer type. CONCLUSIONS This large study identified that cancer patient experiences can be improved in relation to communication, information and supportive care aspects. Improvement efforts should target these areas of care to enhance responsiveness of cancer care.
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Affiliation(s)
- Chantal Arditi
- Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté)University of LausanneLausanneSwitzerland
| | - Manuela Eicher
- Institute of Higher Education and Research in Healthcare (IUFRS), Faculty of Biology and MedicineUniversity of LausanneLausanneSwitzerland,Department of OncologyLausanne University Hospital (CHUV)LausanneSwitzerland
| | - Sara Colomer‐Lahiguera
- Institute of Higher Education and Research in Healthcare (IUFRS), Faculty of Biology and MedicineUniversity of LausanneLausanneSwitzerland
| | - Christine Bienvenu
- Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté)University of LausanneLausanneSwitzerland
| | - Sandro Anchisi
- Oncology ServiceHôpital du Valais ‐ Hospital Center of Valais Romand (CHVR)SionSwitzerland
| | - Daniel Betticher
- Department of OncologyHFR Fribourg – Cantonal HospitalFribourgSwitzerland
| | | | - Michel Duchosal
- Department of OncologyLausanne University Hospital (CHUV)LausanneSwitzerland
| | - Solange Peters
- Department of OncologyLausanne University Hospital (CHUV)LausanneSwitzerland
| | - Isabelle Peytremann‐Bridevaux
- Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté)University of LausanneLausanneSwitzerland
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Alosaimi FD, Alsaleh FS, Alsughayer LY, Altamimi LA, Alfurayh IA, Abdel-Aziz NM, Alsaleh KA. Psychosocial and Clinical Predictors of Patient Satisfaction with Cancer Care. Saudi Pharm J 2022; 30:414-420. [PMID: 35527832 PMCID: PMC9068518 DOI: 10.1016/j.jsps.2022.01.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 01/21/2022] [Indexed: 11/07/2022] Open
Abstract
Purpose Patient satisfaction with healthcare was recognized as an indispensable component of healthcare quality assurance programs for decades. Limited research has explored psychosocial variables impacting patient satisfaction with cancer care. The objective of our study was to identify the level of patient satisfaction with cancer care in Riyadh, Saudi Arabia and determine the psychosocial and clinical predictors of patient satisfaction. Methods A cross-sectional observational study was carried out in 2018–2019 with patients with cancer at the Outpatient Oncology Clinic at King Saud University Medical City in Riyadh, Saudi Arabia. The questionnaire contained a visual analog scale (VAS) of satisfaction with cancer care, a VAS of satisfaction with social support, the Patient Health Questionnaire-9 Depression scale, and the Generalized Anxiety Disorder 7-item scale. Results Out of the 400 patients approached, 280 agreed to participate in the study. Of the 280 patients participating in the study, 65% were satisfied with cancer care. Higher satisfaction was associated with being non-Saudi, being employed, having fewer household residents (≤4), being satisfied with social support, not receiving radiotherapy, and receiving hormonal or biological therapy. Having anxiety or depression was also associated with lower satisfaction. After adjustment for sociodemographic and clinical characteristics, being satisfied with social support, having ≤ 4 household residents, receiving hormonal therapy, and receiving biological therapy rather than radiotherapy were all independent predictors of higher satisfaction with cancer care. Conclusion This study found an inadequate level of patient satisfaction with cancer care. Higher levels of satisfaction were associated with being satisfied with social support, using biological and hormonal therapy, while lower satisfaction was associated with a larger number of household residents (>4), depression, anxiety and using radiotherapy.
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Esser P, Sautier L, Sarkar S, Schilling G, Bokemeyer C, Koch U, Friedrich M, Defossez G, Mehnert-Theuerkauf A. Development and preliminary psychometric investigation of the German Satisfaction with Comprehensive Cancer Care (SCCC) Questionnaire. Health Qual Life Outcomes 2021; 19:147. [PMID: 34001165 PMCID: PMC8130117 DOI: 10.1186/s12955-021-01784-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 04/30/2021] [Indexed: 11/10/2022] Open
Abstract
PURPOSE The assessment of patient satisfaction during treatment is essential to provide patient-centered high-quality cancer care. Nevertheless, no German instrument assesses patient satisfaction with comprehensive cancer care, which not only includes oncological treatment, but also interpersonal quality of care as well as psychosocial support services. Based on the French REPERES-60, we developed the German Patient Satisfaction with Comprehensive Cancer Care (SCCC) questionnaire. METHODS The REPERES-60 was translated and the items were adapted to make it applicable to the German healthcare system and across different tumor entities. Scales of the resulting instrument were extracted via principal axis factoring (PAF). Subsequently, we investigated the reliability (Cronbach's Alpha, CA), discriminatory power (corrected item-scale correlations) and convergent validity (pre-specified correlations of the SCCC with different outcomes). RESULTS The SCCC consisted of 32 items which were subsequently tested among a sample of 333 patients across different tumor entities (response rate: 47%). Average age was 59 years (standard deviation: 14), 63% were male. PAF revealed four multi-item scales named Competence, Information, Access and Support accounting for 71% of the variance. Two single-items scales assess global satisfaction with medical and psychosocial care, respectively. CA across the multi-item scales ranged from .84 to .96. Discriminatory power was sufficiently high, with all r ≥ .5. Convergent validity was largely verified by negative associations of the four multi-item scales with depressive/anxious symptomatology (r ≥ - .18, p < .01) and fatigue/overall symptom burden (r ≥ - .14, p < .01). CONCLUSION We developed a tool to assess patient satisfaction with comprehensive cancer care in Germany. The SCCC showed satisfactory psychometric properties. Further studies are needed to verify these preliminary findings.
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Affiliation(s)
- Peter Esser
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany.
| | - Leon Sautier
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Susanne Sarkar
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Movement Sciences, University of Hamburg, Hamburg, Germany
| | - Georgia Schilling
- "Hubertus Wald" Tumor Centre, University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Clinical Oncology, Asklepios Tumorzentrum Hamburg, Hamburg, Germany
| | - Carsten Bokemeyer
- Department of Internal Medicine II, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Uwe Koch
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Friedrich
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Gautier Defossez
- UFR Médecine Et Pharmacie, Université de Poitiers, Poitiers, France
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
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Hall A, Bryant J, Sanson-Fisher R, Grady A, Proietto A, Doran CM. Top Priorities for Health Service Improvements Among Australian Oncology Patients. PATIENT-RELATED OUTCOME MEASURES 2021; 12:83-95. [PMID: 33994819 PMCID: PMC8114575 DOI: 10.2147/prom.s291794] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 03/31/2021] [Indexed: 11/24/2022]
Abstract
Objective To determine among a sample of Australian cancer patients receiving outpatient oncology care: 1) the most frequently endorsed general health service improvements selected by patients; 2) for the three most endorsed general health service improvements, the proportion of participants endorsing specific health service changes; and 3) sociodemographic, disease and treatment characteristics associated with the most frequently endorsed general health service improvements. Methods A cross-sectional survey was conducted across six outpatient oncology treatment units located in New South Wales, Australia. Patients receiving chemotherapy for any cancer diagnosis at any of six oncology services were recruited. Participants completed an online survey which included the Consumer Preferences Survey. Logistic regression analyses were conducted to identify sociodemographic, disease and treatment characteristics associated with frequently endorsed health service improvements. Results A total of 879 eligible patients initiated the survey (72% consent rate). Participants selected a median of two health service improvements. The three most wanted improvements were car parking (56%), up-to-date information about treatment or condition progress (19%), and hospital catering (17%). Age was the only characteristic significantly associated with identifying car parking as a needed improvement. Conclusion Achieving high quality cancer care requires understanding of the views and experiences of patients about the quality of care they receive. Car parking and access to information were the two most frequently endorsed general health service changes desired by this sample of participants. Practice Implication Future studies could examine whether enacting changes as per patient feedback improves patient perceptions of quality of care, and health outcomes.
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Affiliation(s)
- Alix Hall
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Jamie Bryant
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Robert Sanson-Fisher
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Alice Grady
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Hunter New England Local Health District, Population Health, Wallsend, NSW, Australia
| | - Anthony Proietto
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Christopher M Doran
- Centre for Indigenous Health Equity Research, Central Queensland University, Rockhampton, QLD, Australia
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Li S, Tseng J. Phyllodes patients' perceptions of care: Do they trust their doctors? Breast J 2021; 27:621-623. [PMID: 33779019 DOI: 10.1111/tbj.14229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/11/2021] [Accepted: 03/12/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Suellen Li
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Jennifer Tseng
- Department of Surgery, The University of Chicago Medicine, Chicago, IL, USA
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11
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Díez JJ, Galofré JC. Thyroid cancer patients satisfaction at the management outcome: an analysis of the results of a nationwide survey in 485 subjects. BMC Health Serv Res 2021; 21:158. [PMID: 33602247 PMCID: PMC7890898 DOI: 10.1186/s12913-021-06158-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 02/08/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND We aimed to measure satisfaction of patients with thyroid cancer concerning different aspects of healthcare. METHODS We developed a web-based survey. Questions focused on patient satisfaction with specialists, the health centers and departments, and the information received about their disease. Level of satisfaction was quantified using a scale of 1 to 5. Values ≥4 were considered a high degree of satisfaction. RESULTS Four hundred eighty-five patients (aged 43.4 ± 9.9 yrs., 88% females) completed the survey. A high overall satisfaction with the specialists was reported by 52.5% of patients. The most highly valued specialists were surgeons, oncologists, and endocrinologists. 56.5% of respondents reported a high overall satisfaction with the health centers and departments. Lastly, the proportion of patients who were highly satisfied with the information received was only 42.5%. The presence of complications was indirectly related with satisfaction with specialists and information. Satisfaction with health centers and services was directly related with the level of education and inversely related to the time of evolution of the disease. CONCLUSION Our results show a high degree of overall satisfaction of thyroid cancer patients. However, satisfaction can be improved in some areas, such with regards to the information provided to patients.
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Affiliation(s)
- Juan J Díez
- Department of Endocrinology, Hospital Universitario Puerta de Hierro Majadahonda, Calle Manuel de Falla, 1, 28222 Majadahonda, Madrid, Spain.
- Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana (IDIPHISA), Madrid, Spain.
- Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
- Thyroid Task Force from the Sociedad Española de Endocrinología y Nutrición (SEEN), Madrid, Spain.
| | - Juan C Galofré
- Thyroid Task Force from the Sociedad Española de Endocrinología y Nutrición (SEEN), Madrid, Spain
- Department of Endocrinology, Clínica Universidad de Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
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12
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Factors contributing to satisfaction with care in cancer outpatients. Support Care Cancer 2021; 29:4575-4586. [PMID: 33483788 DOI: 10.1007/s00520-020-05978-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 12/29/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To evaluate satisfaction with care (SC) in cancer patients treated at a Spanish day hospital, to identify determinants of SC, and to assess the association between SC and quality of life (QL). METHODS Cross-sectional study in which 119 patients undergoing outpatient chemotherapy completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the Cancer Outpatient Satisfaction with Care questionnaire for chemotherapy (OUT-PATSAT35 CT), and an item on loyalty. Bivariate correlations between each subscale of the OUT-PATSAT35 CT and overall satisfaction, and between the subscales of OUT-PATSAT35 CT and QLQ-C30, were calculated. Multiple linear regression models were used to analyze determinants of patients' SC. RESULTS Mean age was 62.5 years (SD 11.7), and 54.6% of the sample were female. Mean scores for SC were > 75 out of 100 on all OUT-PATSAT35 CT subscales, except environment. Overall satisfaction was higher than satisfaction in any subscale, and all patients would choose the same day hospital again. Correlation with overall satisfaction was moderate but statistically significant for all subscales. Patients treated for tumor recurrence and those undergoing palliative treatment manifested significantly lower overall satisfaction. Correlation between the EORTC QLQ-C30 and the OUT-PATSAT35 CT was not statistically significant, although patients with better health status reported higher satisfaction in several subscales. CONCLUSION Patient-reported SC and loyalty towards the day hospital were high. Disease evolution and aim of treatment were determinants of overall satisfaction. The correlation between SC and QL was unclear. Some areas for improving care were noted.
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Dee EC, Muralidhar V, Butler SS, Yu Z, Sha ST, Mahal BA, Nguyen PL, Sanford NN. General and Health-Related Internet Use Among Cancer Survivors in the United States: A 2013-2018 Cross-Sectional Analysis. J Natl Compr Canc Netw 2020; 18:1468-1475. [PMID: 33152707 DOI: 10.6004/jnccn.2020.7591] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 05/12/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND A significant proportion of cancer survivors endorse ongoing health information needs and may use the internet to access information. We assessed patterns and predictors of general and health-specific internet use among cancer survivors. METHODS Using data from the National Health Interview Survey (NHIS), which was administered in 2013 through 2018, for adults reporting a cancer diagnosis, sample weight-adjusted estimates defined prevalence and multivariable logistic regressions defined adjusted odds ratios (aORs) of general and health-specific internet use, adjusting for relevant sociodemographic covariates, including healthcare satisfaction as the primary independent variable. The analysis for health-specific internet use was also repeated including a sex (female vs male)*healthcare satisfaction (very satisfied/somewhat satisfied vs somewhat dissatisfied/very dissatisfied) interaction term. RESULTS Among 12,970 survivors of cancer, general and health-specific internet use increased from 2013 to 2018 (from 63.2% to 70.8% and from 46.8% to 52.2%, respectively; P<.05 for both). Survivors who were very dissatisfied with healthcare were more likely to use the internet for health information compared with those who were very satisfied (59.5% vs 48.0%; aOR, 1.78; 95% CI, 1.20-2.64; P=.004). Younger age, female sex, higher educational attainment, and higher socioeconomic status were all associated with increased reported use of the internet for both general and health-specific purposes (P<.001 for all). There was a significant sex*healthcare satisfaction interaction (P=.009) such that for female survivors, healthcare dissatisfaction was associated with higher odds of health-specific internet use (61.4% vs 52.5%; P<.001; men, P=.97). No association was found between healthcare satisfaction and general internet use (P=.42). CONCLUSIONS The increasing proportion of survivors of cancer using the internet for health-specific information may be associated with self-reported dissatisfaction with healthcare. Efforts are needed to improve both access to the internet and the quality of cancer-relevant online health information, and to enhance patients' online health literacy.
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Affiliation(s)
| | | | - Santino S Butler
- Harvard Medical School, and.,Dana-Farber Cancer Institute, Boston, Massachusetts
| | | | - Sybil T Sha
- Geisel School of Medicine, Hanover, New Hampshire
| | - Brandon A Mahal
- Department of Radiation Oncology, University of Miami Miller School of Medicine, and.,Office of Community Outreach and Engagement, Sylvester Comprehensive Cancer Center, Miami, Florida; and
| | | | - Nina N Sanford
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
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14
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Gomez-Cano M, Lyratzopoulos G, Abel GA. Patient Experience Drivers of Overall Satisfaction With Care in Cancer Patients: Evidence From Responders to the English Cancer Patient Experience Survey. J Patient Exp 2020; 7:758-765. [PMID: 33294612 PMCID: PMC7705845 DOI: 10.1177/2374373519889435] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Surveys collecting patient experience data often contain a large number of items covering a wide range of experiences. Knowing which areas to prioritize for improvements efforts can be difficult. OBJECTIVE To examine which aspects of care experience are the key drivers of overall satisfaction with cancer care. METHODS Secondary analysis of the National Cancer Patient Experience Survey. Logistic regression was used to examine the relationship between overall satisfaction and 10 core questions covering aspects of experience applicable to all patients. Supplementary analyses examined a further 16 questions applying only to patients in certain groups or on specific treatment pathways. RESULTS Of 68 340 included patients, 58 697 (86%) rated overall satisfaction highly (8 or more out of 10). The strongest predictors of overall satisfaction across all models were responses to 2 questions on experience of care administration and care coordination (odds ratio [OR] = 2.11, 95% confidence interval [95% CI = 2.05-2.17, P < .0001; OR = 2.03, 95% CI = 1.97-2.09, P < .0001, respectively, per 1 standard deviation change). CONCLUSION Focusing improvement efforts on care administration and coordination has potential to improve overall satisfaction with oncological care across diverse patient groups/care pathways.
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Affiliation(s)
- Mayam Gomez-Cano
- University of Exeter Medical School, University of Exeter, Exeter, United Kingdom
| | - Georgios Lyratzopoulos
- Epidemiology of Cancer Healthcare & Outcomes (ECHO) Group, Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, United Kingdom
| | - Gary A Abel
- University of Exeter Medical School, University of Exeter, Exeter, United Kingdom
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Abstract
Prostate cancer is the second most common cause of cancer-related death in men in the USA, but the effect of prostate cancer diagnosis and treatment on men in a sexual minority group, including men who have sex with men and transgender women, is poorly understood. Efforts to study this population are complicated, as cancer registries do not routinely collect information on sexual orientation. As a result, epidemiological data regarding this population have come from small studies that have included disparate rates of prostate cancer screening, diagnosis and treatment. Qualitative studies indicate that prostate cancer is experienced differently by sexual minorities, with distinct health-care needs that arise owing to differences in sexual practices, social support systems and relationships with the medical community. Notably, sexual minorities have been reported to experience poorer health-related quality of life outcomes than heterosexual men, and tend to have less robust social support systems, experience increased psychological distress caused by sexual dysfunction (areas of which are unmeasured after treatment), experience isolation within the health-care system and express increased levels of dissatisfaction with treatment. The incidence of prostate cancer actually seems to be decreased in men from sexual minorities living with HIV, despite there being no differences in screening and treatment, with poor cancer-specific mortality. Although the literature on patients with prostate cancer in men from sexual minority groups has historically been sparse, peer-reviewed research in this area has grown considerably during the past decade and has become an important field of study.
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Abate D, Aman MA, Nasir BB, Gebremariam GT, Fentie AM. Assessment of Quality of Care Using Information on Patient Satisfaction at Adult Oncology Center of Tikur Anbessa Specialized Hospital, Ethiopia: A Cross-Sectional Study. Patient Prefer Adherence 2020; 14:847-858. [PMID: 32546979 PMCID: PMC7247603 DOI: 10.2147/ppa.s253027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 05/07/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Cancer is one of the leading causes of morbidity and mortality in the world. It results in considerable mental, physical, and emotional stress for patients. Because of the nature and impact of the disease, and its treatment, measurements of patient satisfaction are important to bring to the attention of health-care providers in order to improve care. OBJECTIVE To assess patient satisfaction at the adult oncology center of Tikur Anbessa Specialized Hospital, Ethiopia using the EORTC PATSAT-C33 tool. METHODS A facility-based cross-sectional study was conducted from January 2019 to May 2019. A consecutive sampling technique was employed to recruit a total of 384 study participants. Informed consent was obtained for each participant and data were collected using an interviewer-administered questionnaire. Ethical clearance and approval of the study protocol were obtained from the institutional ethics review board of the school of pharmacy. Descriptive statistics was used to summarize the data, while multivariate linear regression analysis was employed to explore factors affecting patient satisfaction. P<0.05 was considered as statistically significant. RESULTS Among a total of 384 study participants, the majority were female (65.9%) and the median age was 49 years. In most (65.9%) participants, the health-care service cost was covered by patients themselves; the majority of them were treated for gynecological malignancy (37.2%) and most received chemotherapy + surgery (37.2%). The mean score for the EORTC-PATSAT33 scales for overall satisfaction was 44.8 out of 100. Place of residence, gender, type of cancer, duration since treatment started, age and source of health-care costs were factors associated with patient satisfaction and all together explained 83% (adjusted R square=0.830, P<0.0001) of variance. Of these, residence (where patients came from) accounted for most (78.7%) of the variance (adjusted R square=0.787, P<0.0001). CONCLUSION The mean overall satisfaction of patients with the services provided at the outpatient adult oncology center of TASH was significantly lower than previously reported in the world literature, which was >70. Hence, a concerted effort must be made to understand and improve patient satisfaction in oncology health-care services in Ethiopia.
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Affiliation(s)
- Dessale Abate
- Tikur Anbessa Specialized Hospital, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Munir Awol Aman
- Tikur Anbessa Specialized Hospital, Adult Oncology Center, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Beshir Bedru Nasir
- Tikur Anbessa Specialized Hospital, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Girma Tekle Gebremariam
- Tikur Anbessa Specialized Hospital, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Atalay Mulu Fentie
- Tikur Anbessa Specialized Hospital, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Correspondence: Atalay Mulu Fentie PO Box: 1176Tel +251923295462 Email
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The acceptance and applicability of a patient-reported experience measurement tool in oncological care: a descriptive feasibility study in northern Germany. BMC Health Serv Res 2019; 19:786. [PMID: 31675968 PMCID: PMC6825358 DOI: 10.1186/s12913-019-4646-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 10/16/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) are tools for assessing outcomes of and experiences with health care from the patient's perspective. In Germany, PROMs are widely used in research for evaluating patient outcomes and quality of care. However, the application of PREMs is rather scant, especially in oncology. The study aimed to assess the feasibility of patient-centred quality evaluation in oncological care in Germany using the German adaptation of the Danish National Cancer Patient Questionnaire. This questionnaire is a PREM/PROM-tool addressing patients of all cancer sites and covering the entire cancer patient pathway. METHODS The Danish National Cancer Patient Questionnaire was translated into German via forward-backward translation. Face-validity was tested among three cancer patients in a conventional pre-test. The German adaptation contains 99 questions. A pilot test was carried out among 245 newly diagnosed breast and colorectal cancer patients in the German federal state Schleswig-Holstein. Patients were recruited via clinics participating in the Oncological Care Registry (12 specialised units in seven hospitals) and contacted six to nine months after diagnosis. Response behaviour and response patterns were compared to the Danish study population (n = 1964). RESULTS The willingness among clinicians to support patient recruitment as well as the response rate of patients to the questionnaire was high (65%). Moreover, response behaviour and response patterns of German and Danish patients were consistent. Despite the generally good response behaviour of patients to the single items, the authors observed that questions assessing the diagnostic process did not fully capture German pathways. Only 19.3% of the German patients stated that their diagnostic process was initiated by a visit to a general practitioner (GP) in contrast to 52% in Denmark. The assessment of patient experiences in the diagnostic phase heavily focuses on experiences in general practice, which does not seem appropriate in the German health care setting. CONCLUSION The translation was successful, and the feasibility of a future large-scale study within existing structures is given. However, some modifications of questions heavily related to the Danish health care system, especially referring to the diagnostic phase, are necessary.
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18
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Hudson BF, Best S, Stone P, Noble T(B. Impact of informational and relational continuity for people with palliative care needs: a mixed methods rapid review. BMJ Open 2019; 9:e027323. [PMID: 31147362 PMCID: PMC6549611 DOI: 10.1136/bmjopen-2018-027323] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To identify and synthesise existing literature exploring the impact of relational and informational continuity of care on preferred place of death, hospital admissions and satisfaction for palliative care patients in qualitative, quantitative and mixed methods literature. DESIGN A mixed methods rapid review. METHODS PUBMED, PsychINFO, CINAHL were searched from June 2008 to June 2018 in order to identify original peer reviewed, primary qualitative, quantitative or mixed methods research exploring the impact of continuity of care for people receiving palliative care. Synthesis methods as outlined by the Cochrane Qualitative and Implementation Methods Group were applied to qualitative studies while meta-analyses for quantitative data were planned. OUTCOMES The impact of interventions designed to promote continuity of care for people receiving palliative care on the following outcomes was explored: achieving preferred place of death, satisfaction with care and avoidable hospital admissions. RESULTS 18 eligible papers were identified (11 qualitative, 6 quantitative and 1 mixed methods papers). In all, 1951 patients and 190 family caregivers were recruited across included studies. Meta-analyses were not possible due to heterogeneity in outcome measures and tools used. Two studies described positive impact on facilitating preferred place of death. Four described a reduction in avoidable hospital admissions. No negative impacts of interventions designed to promote continuity were reported. Patient satisfaction was not assessed in quantitative studies. Participants described a significant impact on their experiences as a result of the lack of informational and relational continuity. CONCLUSIONS This rapid review highlights the impact that continuity of care can have on the experiences of patients receiving palliative care. The evidence for the impact of continuity on place of death and hospital admissions is limited. Methods for enhancing, and recording continuity should be considered in the design and development of future healthcare interventions to support people receiving palliative care.
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Affiliation(s)
- Briony F Hudson
- Marie Curie, London, UK
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | | | - Patrick Stone
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
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Dos Santos M, Lequesne J, Dugué AE, Grellard JM, Ory C, Jaffré S, Lavergne K, Lelaidier A, Laroche L, Divanon F, Delcambre C, Galais MP, Clarisse B, Faveyrial A. Optimisation of chemotherapy prescription and preparation in an ambulatory unit: Validation of the OPTIMA program. Eur J Cancer Care (Engl) 2019; 28:e13015. [PMID: 30790365 DOI: 10.1111/ecc.13015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 01/18/2019] [Accepted: 01/22/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE We implemented the two-step OPTIMA program to anticipate chemotherapy prescription which aims to assess the discrepancy rate between anticipated and real prescription and its impact on waiting time and quality of care. METHODS This prospective study included cancer patients receiving any intravenous chemotherapy. The OPTIMA program consists in a nurse phone call and a blood sample two days before the planned treatment. Collected information and biological results were used by a physician to issue a non-effective (step 1) or effective (step 2) anticipated prescription the day before the consultation. The real prescription was given as usual by another physician on the day of the consultation. Waiting time was collected, and patients' satisfaction with care was assessed with the OUT-PATSAT35 questionnaire. RESULTS Respectively, 540 and 979 consultations (283 and 294 patients) were analysed in both steps. The discrepancy rate was 8.7% (step 1). In routine practice, the OPTIMA program (step 2) reduced patients' waiting time (median time 55 vs. 95 min, p < 0.001). A high general care satisfaction score was observed in both steps (80.7% and 80.2%). CONCLUSIONS This anticipation program demonstrated the accuracy of chemotherapy prescription, whatever the regimen and cancer site, and its impact on waiting time optimisation.
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Affiliation(s)
- Mélanie Dos Santos
- Clinical Research Unit, Centre François Baclesse, Caen, France.,Department of Medicine, Hospital University, Caen, France
| | | | | | | | - Céline Ory
- Ambulatory Department, Centre François Baclesse, Caen, France
| | | | - Kelly Lavergne
- Clinical Research Unit, Centre François Baclesse, Caen, France
| | - Anaïs Lelaidier
- Northwest Data Center (CTD-CNO), Centre François Baclesse, Caen, France
| | - Lucie Laroche
- Northwest Data Center (CTD-CNO), Centre François Baclesse, Caen, France
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Knoerl R, Hong F, Blonquist T, Berry D. Impact of Electronic Self-Assessment and Self-Care Technology on Adherence to Clinician Recommendations and Self-Management Activity for Cancer Treatment-Related Symptoms: Secondary Analysis of a Randomized Controlled Trial. JMIR Cancer 2019; 5:e11395. [PMID: 30622093 PMCID: PMC6329427 DOI: 10.2196/11395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 10/18/2018] [Accepted: 11/04/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patients undergoing cancer treatment experience symptoms that negatively affect their quality of life and adherence to treatment. The early identification and management of treatment-related symptoms are critical to prevent symptom distress due to unmanaged symptoms. However, the early identification and management of treatment-related symptoms are complex as most cancer treatments are delivered on an outpatient basis where patients are granted less face-to-face time with clinicians. The Electronic Symptom Assessment and Self-Care (ESRA-C) promotes participant self-management of treatment-related symptoms by providing participants with communication coaching and symptom self-report, education, and tracking features. While the ESRA-C intervention has been demonstrated to improve symptom distress significantly, little is known as to how the ESRA-C influenced participants' self-management practices and adherence to clinician recommendations for symptom/quality of life issues (SQIs). OBJECTIVE To compare participant adherence to clinician recommendations and additional self-management strategy use for SQIs between ESRA-C intervention and control (electronic symptom assessment and participant symptom reports alone) group participants. Secondarily, we explored the impact of participant adherence to clinician recommendations and additional self-management strategy use for SQIs on symptom control, symptom management satisfaction, and symptom distress. Lastly, we examined baseline predictors of participant adherence to clinician recommendations and additional self-management strategy use for SQIs. METHODS This study presents an analysis of a randomized controlled trial. Participants beginning a new chemotherapy or radiotherapy regimen were recruited from oncology outpatient centers and were randomized to receive the ESRA-C intervention or control during treatment. Patients were included in this analysis if they remained on study through the duration of treatment and self-reported at least one bothersome SQI three-to-six weeks after beginning treatment. The Symptom Distress Scale-15 and Self-Management of SQIs Questionnaire were completed two weeks later. Based on Self-Management of SQIs Questionnaire ratings, participants were placed into adherence to clinician recommendations (adhered/did not adhere/did not receive recommendations) and additional self-management strategy use (yes/no) categories. RESULTS Most participants were adherent to clinician recommendations (273/370, 73.8%), while fewer used additional self-management strategies for SQIs (182/370, 49.2%). There were no differences in the frequency of participant adherence to clinician recommendations (chi-square test, P=.99) or self-management strategy use (chi-square test, P=.80) between intervention (n=182) and control treatment groups (n=188). Participants who received clinician recommendations reported the highest treatment satisfaction (n=355, P<.001 by analysis of variance; ANOVA), although lowest distress was reported by participants who did not follow clinician recommendations (n=322, P=.04 by ANOVA) for top 2 SQIs. Women (n=188) reported greater additional self-management strategy use than men (n=182, P=0.03 by chi-square test). CONCLUSIONS ESRA-C intervention use did not improve participants' adherence to clinician recommendations or additional self-management strategy use for SQIs in comparison to the control. Future research is needed to determine which factors are important in improving patients' self-management practices and symptom distress following ESRA-C use. TRIAL REGISTRATION ClinicalTrials.gov NCT00852852; https://clinicaltrials.gov/ct2/show/NCT00852852 (Archived by WebCite at http://www.webcitation.org/73rEhNWkU).
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Affiliation(s)
- Robert Knoerl
- Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Fangxin Hong
- Department of Biostatistics & Computational Biology, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Traci Blonquist
- Department of Biostatistics & Computational Biology, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Donna Berry
- Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, MA, United States
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21
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Bergengren O, Garmo H, Bratt O, Holmberg L, Johansson E, Bill-Axelson A. Satisfaction with Care Among Men with Localised Prostate Cancer: A Nationwide Population-based Study. Eur Urol Oncol 2018; 1:37-45. [PMID: 31100227 DOI: 10.1016/j.euo.2018.02.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 01/26/2018] [Accepted: 02/08/2018] [Indexed: 10/14/2022]
Abstract
BACKGROUND Information about how men with prostate cancer (PC) experience their medical care and factors associated with their overall satisfaction with care (OSC) is limited. OBJECTIVE To investigate OSC and factors associated with OSC among men with low-risk PC. DESIGN, SETTING, AND PARTICIPANTS Men registered in the National Prostate Cancer Register of Sweden as diagnosed in 2008 with low-risk PC at the age of ≤70 yr who had undergone radical prostatectomy (RP), radiotherapy (RT), or started on active surveillance (AS) were invited in 2015 to participate in this nationwide population-based survey (n=1720). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS OSC data were analysed using ordinal logistic regression. Odds ratios (ORs) were calculated for comparisons between the highest and lowest possible response categories. RESULTS AND LIMITATIONS A total of 1288 men (74.9%) responded. High OSC was reported by 958 (74.4%). Factors associated with high OSC were high participation in decision-making (OR 4.18, 95% confidence interval [CI] 2.61-6.69), receiving more information (OR 11.1, 95% CI 7.97-15.6), high-quality information (OR 7.85, 95% CI 5.46-11.3), access to a nurse navigator (OR 1.80, 95% CI 1.44-2.26), and better functional outcomes (defined as 25 points higher on the EPIC-26 questionnaire; OR 1.34, 95% CI 1.21-1.48). OSC was not affected by whether a doctor or specialist nurse conducted follow-up (OR 0.84, 95% CI 0.66-1.07). These findings were similar across treatment groups. Men who had undergone RP or RT reported high OSC more often than men on AS (78.2% vs 84.0% vs 72.6%), high participation in decision-making (70.5% vs 64.5% vs 49.2%), and having received more information (40.5% vs 45.8% vs 28.6%), and were less likely to believe they would die from PC (3.8% vs 3.9% vs 8.0%). Limitations include the nonrandomised retrospective design and potential recall bias. CONCLUSIONS Information and participation in decision-making, as well as access to a nurse navigator, are key factors for OSC, regardless of treatment. Men on AS need more information about their treatment and need to participate more in decision-making. OSC was as high among men who had nurse-led follow-up as among men who had doctor-led follow-up. PATIENT SUMMARY Information about how men with low-risk prostate cancer experience their medical care is limited. In this nationwide population-based study we found that information and participation in decision-making as well as access to a nurse navigator are key factors for satisfaction regardless of treatment. Men who are being closely watched for prostate cancer without immediate curative treatment need more information than they now receive and need to participate more in decision-making than they currently do.
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Affiliation(s)
- Oskar Bergengren
- Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden.
| | - Hans Garmo
- Regional Cancer Centre Uppsala Örebro, Uppsala University Hospital, Uppsala, Sweden
| | - Ola Bratt
- Department of Urology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lars Holmberg
- Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden
| | - Eva Johansson
- Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden
| | - Anna Bill-Axelson
- Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden
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