Experiences of older patients with cancer from the radiotherapy pathway - A qualitative study

Care quality and satisfaction at the cancer hospital - a questionnaire study of older patients with cancer and their family members

BACKGROUND

The unique life situations of older patients with cancer and their family members requires that health care professionals take a holistic approach to achieve quality care. The aim of this study was to assess the perceptions of older patients with cancer and family members about the quality of care received and evaluate differences between their perceptions. A further aim was to examine which factors explain patients' and family members' levels of satisfaction with the care received.

METHODS

The study was descriptive and cross-sectional in design. Data were collected from patients (n = 81) and their family members (n = 65) on four wards in a cancer hospital, using the Revised Humane Caring Scale (RHCS). Data were analysed using descriptive statistics, crosstabulation, Wilcoxon signed rank test, and multivariable Analysis of Covariance (ANCOVA).

RESULTS

Family members had more negative perceptions of the quality of care than patients did. Dissatisfaction was related to professional practice (p < 0.001), interaction between patient and health care professionals (p < 0.001), cognition of physical needs (p = 0.024), and human resources (p < 0.001). Satisfaction with overall care was significantly lower among those patients and family members who perceived that they had not been involved in setting clear goals for the patient's care with staff (p = 0.002).

CONCLUSIONS

It is important that older patients with cancer and family members receive friendly, respectful, individual care based on their needs and hopes, and that they can rely on professionals. Health care professionals need more resources and education about caring for older cancer patients to provide quality care.

Patient-Reported Experiences and Associated Factors in a Norwegian Radiotherapy Setting: An Explorative Cross-Sectional Study

Introduction

Radiotherapy is the main treatment modality in cancer. There is sparse knowledge on how patients with cancer experience their radiotherapy trajectory, and which factors might be associated with patients' experiences.

Objectives

The aim of the present study was to explore how adults with cancer receiving radiotherapy evaluate the quality of their care, utilizing a patient-reported experience measure, and how patient- and service-related characteristics are associated with their evaluation.

Methods

An explorative cross-sectional study using a self-completed questionnaire to assess patients' radiotherapy experiences was performed. Participants were recruited consecutively, within their last week of treatment, from two different hospitals in Norway from January 2021 to January 2022. Four hundred and eighty paper questionnaires were distributed to recruited patients, 240 at each hospital. Questionnaires were self-completed at home and returned by mail. The instrument person-centered coordinated care experience questionnaire (P3CEQ) was used. In addition to this, participants completed the European Organization of Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30) and The Sense of Coherence 13 scale (SOC-13). Data were analyzed using descriptive statistics, parametric tests, and unadjusted/adjusted linear regression models were estimated.

Results

The study included 373 patients. Patients evaluated quality of care in terms of P3CEQ scores, with a mean score of 19.5 (standard deviation = 5.4). Lowest scores were identified in areas concerning person-centeredness and service coordination. There were no significant differences in P3CEQ scores between the younger and older groups. Having a partner and better SOC-13 scores were independently associated with the overall patient-reported experience score, whereas age was not.

Conclusion

Patient-reported experience scores indicate that improvements are needed in some areas, such as informing and involving patients in the planning and coordination of their care. Findings suggest paying special attention to patients without a partner to offer patients the best possible care.

Psychometric Properties of the Person-Centred Coordinated Care Experience Questionnaire (P3CEQ) in a Norwegian Radiotherapy Setting

BACKGROUND

The number of older adults with cancer is increasing. Radiotherapy is an important treatment modality in cancer, and may cause side effects and distress. Patient-reported experience measures aim to measure patients' experience with health care. This can help health care services to improve in line with patients' needs. To assess how Norwegian patients receiving radiotherapy experience their care, a valid and reliable tool is required. We selected the Person-centred coordinated care experience questionnaire as a tool. The aim of the study is to validate the Norwegian version of this questionnaire in a radiotherapy setting.

METHODS

A feasibility study of the Person-centred coordinated care experience questionnaire and a cross-sectional study - testing psychometric properties of the questionnaire in a Norwegian radiotherapy setting - were conducted. Participants were recruited from two different hospitals in Norway. Patient characteristics and item scores are described using descriptive statistics. We performed an exploratory factor analysis, and applied principal component analysis with a varimax rotation. Cronbach's α was used to assess internal consistency.

RESULTS

24 patients participated in the feasibility test, and 176 were included in the cross-sectional study where we explored the psychometric properties of the Person-centred coordinated care experience questionnaire. Three factors were identified. Internal consistency was established for the ten-item scale, with Cronbach's α = 0.698.

CONCLUSION

Conclusions must consider the Norwegian setting and health care context. We found that the Norwegian version of the Person-centred coordinated care experience questionnaire is a relevant, valid, and reliable tool to provide insight into different areas of patients' experiences upon receiving radiotherapy. However, further testing on a larger sample is necessitated.