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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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Martin D, Alberti P, Wigmore SJ, Demartines N, Joliat GR. Pancreatic Cancer Surgery: What Matters to Patients? J Clin Med 2023; 12:4611. [PMID: 37510726 PMCID: PMC10380608 DOI: 10.3390/jcm12144611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 06/28/2023] [Accepted: 07/08/2023] [Indexed: 07/30/2023] Open
Abstract
Pancreatic cancer is a leading cause of cancer-related death, with a poor overall survival rate. Although certain risk factors have been identified, the origins of pancreatic cancer are still not fully understood. Surgical resection remains the primary curative treatment, but pancreatic surgery is still associated with high morbidity and mortality rates, and most patients will experience recurrence. The impact of pancreatic cancer on patients' quality of life is significant, with an important loss of healthy life in affected individuals. Traditional outcome parameters, such as length of hospital stay, do not fully capture what matters to patients during recovery. Patient-centered care is therefore central, and the patient's perspective should be considered in pre-operative discussions. Patient-reported outcome and experience measures (PROMs and PREMs) could play an important role in assessing patient perspectives, but standardized methodology for evaluating and reporting them is needed. This narrative review aims to provide a comprehensive overview of patient perspectives and different patient-reported measures in pancreatic cancer surgery. Understanding the patient perspective is crucial for delivering patient-centered care and improving outcomes for patients with pancreatic cancer.
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Affiliation(s)
- David Martin
- Department of Visceral Surgery, University Hospital CHUV, University of Lausanne (UNIL), 1005 Lausanne, Switzerland
- Department of Surgery, Hepatobiliary and Pancreatic Unit, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
| | - Piero Alberti
- Department of Surgery, Hepatobiliary and Pancreatic Unit, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
| | - Stephen J Wigmore
- Department of Surgery, Hepatobiliary and Pancreatic Unit, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
| | - Nicolas Demartines
- Department of Visceral Surgery, University Hospital CHUV, University of Lausanne (UNIL), 1005 Lausanne, Switzerland
| | - Gaëtan-Romain Joliat
- Department of Visceral Surgery, University Hospital CHUV, University of Lausanne (UNIL), 1005 Lausanne, Switzerland
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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: 8] [Impact Index Per Article: 4.0] [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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Cona MS, Mancuso AM, Russo A, Rota S, Piva S, La Verde N. Fight against cancer in Italy: What patients, caregivers and healthy citizens think about care delivery from National Health System. Eur J Cancer Care (Engl) 2022; 31:e13763. [DOI: 10.1111/ecc.13763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/03/2022] [Accepted: 10/09/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Maria Silvia Cona
- Department of Oncology Luigi Sacco Hospital, ASST Fatebenefratelli Sacco Milan Italy
| | | | - Antonio Russo
- Department of Surgical, Oncological and Oral Sciences University of Palermo Palermo Italy
| | - Selene Rota
- Department of Oncology Luigi Sacco Hospital, ASST Fatebenefratelli Sacco Milan Italy
| | - Sheila Piva
- Department of Oncology Fatebenefratelli Hospital, ASST Fatebenefratelli Sacco Milan Italy
| | - Nicla La Verde
- Department of Oncology Luigi Sacco Hospital, ASST Fatebenefratelli Sacco Milan Italy
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Factors influencing cancer survivors' experiences with follow-up cancer care: results from the pan-Canadian Experiences of Cancer Patients in Transition Study survey. Support Care Cancer 2022; 30:9559-9575. [PMID: 36123549 DOI: 10.1007/s00520-022-07357-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 09/06/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE The purpose of this study was to examine the influence of individual and structural factors on cancer survivors' experiences with follow-up cancer care. METHODS In 2016, the Canadian Partnership Against Cancer collected survey responses from cancer survivors about their experiences with follow-up cancer care. We included respondents from this survey if they were diagnosed with non-metastatic breast, hematologic, colon, melanoma, and prostate cancer. Our primary outcome was cancer survivors' self-reported overall experience with follow-up cancer care. We used multivariable logistic regression to examine the influence of individual and structural factors on cancer survivors' experiences with follow-up cancer care. RESULTS Of the 8402 cancer survivors included in our study, 81.8% (n = 6,875) reported a positive experience with their follow-up cancer care. The individual factors associated with positive overall experiences were more commonly those associated with self-perceptions of respondents' personal health and well-being rather than baseline sociodemographic factors, such as sex, income, or education. For example, respondents were more likely to report a positive experience if they perceived their quality of life as good (OR 1.9, 95% CI 1.0-3.5, p < 0.01) or reported not having an unmet practical concern (OR 1.3, 95% CI 1.1-1.6, p < 0.01). The structural factors most strongly associated with positive overall experiences included respondents perceiving their oncology specialist was in charge of their follow-up cancer care (OR 5.2, 95% CI 3.6-7.5, p < 0.01) and reporting the coordination of their follow-up cancer care among healthcare providers was good or very good (OR 8.4, 95% CI 6.7-10.6, p < 0.01). CONCLUSION While real-world experiences with follow-up cancer care in Canada are reported to be positive by most cancer survivors included in this study, we found differences exist based on individual and structural factors. A better understanding of the reasons for these differences is required to guide the provision of high-quality follow-up care that is adapted to the needs and resources of individuals and contexts.
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Fit theory: A cancer experience grounded theory emerging from semi-structured interviews with cancer patients and informal caregivers in Manitoba Canada during the COVID-19 pandemic. PLoS One 2022; 17:e0269285. [PMID: 35867713 PMCID: PMC9307189 DOI: 10.1371/journal.pone.0269285] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 05/17/2022] [Indexed: 11/19/2022] Open
Abstract
Background It is not clear how changes to healthcare delivery related to the COVID-19 pandemic, including virtual care and social distancing restrictions, have impacted the experience of living with cancer. This study aimed to discover a theory capable of describing the cancer experience, how the pandemic impacted it, and for guiding predictions about how to improve it. Methods Between October 2020 and July 2021 digitally recorded semi-structured one-on-one interviews were conducted virtually with adult cancer patients and informal caregivers in Manitoba, Canada. Transcriptions and field notes from the interviews were analyzed using classic grounded theory. Results Interviews with 33 patients and 6 informal caregivers were conducted. Fit emerged as the core concept of the theory and describes the relationship between the healthcare system and the unique combination of characteristics each patient has. Good fit results in a positive experience and poor fit in a negative experience. Virtual care improves fit in clinical situations where non-verbal communication and physical examination are not important. Support from informal caregivers improves fit. Social distancing restrictions reduce the ability of informal caregivers to provide support. Conclusions The impact of fit on the cancer experience suggests that care delivery should be tailored to both the individual needs of the patient and the intention of the clinical interaction. Developing evidence-based strategies to inform the integration of virtual care into oncology practice, with aim of promoting good fit between patients and healthcare services, is an important future direction.
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Moens K, Peeters M, Van den Bulcke M, Leys M, Horlait M. Development, Testing, and Implementation of the Belgian Patient Reported Experience Measure for Pancreatic Cancer Care (PREPARE) Project: Protocol for a Multi-Method Research Project. JMIR Res Protoc 2022; 11:e29004. [PMID: 35666559 PMCID: PMC9210207 DOI: 10.2196/29004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 03/30/2022] [Accepted: 04/28/2022] [Indexed: 11/25/2022] Open
Abstract
Background Patients with pancreatic cancer do not feel involved in the development of their treatment and care plans. In Belgium, these plans are decided on during multidisciplinary team meetings. However, limited time is spent on the discussion of the preferences of the patient during these meetings. This research project aims to develop a patient-reported experience measure (PREM) for pancreatic cancer and assess if its use can support collaborative treatment decision-making. Objective This paper aims to outline the protocol for a multi-method research project to improve person-centered pancreatic cancer care in Belgium. Three subobjectives are pursued: (1) to develop a PREM to assess the experiences of care-related aspects in pancreatic cancer care, (2) to validate the PREM, and (3) to develop and evaluate an educational intervention to support the use of the PREM’s results. Methods For the development of the PREM, an exploratory mixed methods study design will be used. The study will start with a survey followed by a telephone interview involving patients with pancreatic cancer and digestive oncology health care professionals. Study two is the testing of the content and construct validity of the PREM. Study three involves the implementation study according to the Medical Research Council framework of a complex intervention introducing the PREM in practice. The effectiveness of the intervention will be investigated using a pragmatic randomized controlled trial study design. Results The protocol presents the entire structure of the research project. Ethics approval to conduct the exploratory mixed methods study (objective 1) has been obtained, and recruitment has started since January 2022. Conclusions The poor prognosis of patients with pancreatic cancer should not be considered a hurdle to not study this patient population group. Involving patients in the research and decision-making processes early on is key. This project aims to realize a scientifically sound research process providing research outputs that can easily and timely be implemented in the care trajectory of patients with pancreatic cancer. This research project will also lead to recommendations on how to involve patients with pancreatic cancer and how the methodology of this research project can be translated to other patient groups. International Registered Report Identifier (IRRID) PRR1-10.2196/29004
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Affiliation(s)
| | - Marc Peeters
- University Hospital Antwerp (UZA), Antwerp, Belgium
| | | | - Mark Leys
- Organisation, Policy & Social Inequalities in Healthcare Research Group (OPIH), Vrije Universiteit Brussels, Brussels, Belgium
| | - Melissa Horlait
- Organisation, Policy & Social Inequalities in Healthcare Research Group (OPIH), Vrije Universiteit Brussels, Brussels, Belgium
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Alessy SA, Alhajji M, Rawlinson J, Baker M, Davies EA. Factors influencing cancer patients' experiences of care in the USA, United Kingdom, and Canada: A systematic review. EClinicalMedicine 2022; 47:101405. [PMID: 35497061 PMCID: PMC9046116 DOI: 10.1016/j.eclinm.2022.101405] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/23/2022] [Accepted: 04/01/2022] [Indexed: 11/01/2022] Open
Abstract
The extent to which individual and structural factors influence cancer patients' reports of their experiences are not yet well understood. We sought to identify which groups of patients consistently report poorer experiences and whether structural care factors might also be associated with better or worse reports. We conducted a systematic review of literature in PubMed and Web of Science with the date of last search as 27th of February 2022 following PRISMA guidelines. We focused on studies from three established population-based surveys datasets and instruments. After screening 303 references, 54 studies met the inclusion criteria. Overall, being from an ethnic minority group, having a more deprived socioeconomic status, poorer general or mental health status, being diagnosed with poor prognosis cancers, presenting to care through an emergency route, and having delayed treatment were consistently associated with poorer cancer care experiences. Conversely being diagnosed with earlier stage disease, perceiving communication as effective, positive patient-provider relationships, and receiving treatment with respect were overall associated with better reports of cancer care experiences. Improvement efforts aimed at delivering better experiences of patient-centred care need to take account much more explicitly patients' differing characteristics, prognoses, and trajectories they take through their care journeys.
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Affiliation(s)
- Saleh A. Alessy
- Public Health Department, College of Health Sciences, Saudi Electronic University, Riyadh, Saudi Arabia
- Centre for Cancer, Society & Public Health, Comprehensive Cancer Centre, King’s College London, London, SE1 9RT, UK
| | - Mohammed Alhajji
- Behavioural Insights Unit (Nudge), Ministry of Health, Riyadh, Saudi Arabia
| | - Janette Rawlinson
- Patient representative, National Cancer Research Institute (NCRI), Consumer forum, NCRI CSG (Lung) Subgroup, BTOG Steering Committee, NHSE CEG, UK
| | - Matthew Baker
- Patient representative, National Cancer Research Institute (NCRI), Consumer Involvement Advisory Group, Consumer Forum, UK
| | - Elizabeth A. Davies
- Centre for Cancer, Society & Public Health, Comprehensive Cancer Centre, King’s College London, London, SE1 9RT, UK
- Corresponding author.
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Williams PAH, Lovelock B, Cabarrus T. A Sense of Coherence approach to improving patient experience using information infrastructure modelling. JMIR Form Res 2022; 6:e35418. [PMID: 35307641 PMCID: PMC9044153 DOI: 10.2196/35418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/03/2022] [Accepted: 03/17/2022] [Indexed: 11/17/2022] Open
Abstract
Background Health care provider organizations are complex and dynamic environments. Consequently, how the physical and social environment of such organizations interact with an individual is a primary driver of an individual’s experience. Increasingly, the capabilities required for them to successfully interact with those within their care are critically dependent on the information infrastructure they have in place, which enables people, both patients and staff, to work optimally together to deliver their clinical and operational objectives. Objective This study aims to design a framework to address the challenge of how to assemble information systems in health care to support an improved sense of coherence for patients, as well as potentially innovate patients’ experiences, by connecting and orchestrating the synergy among people, processes, and systems. Methods It is necessary to understand the needs of health care providers and patients to address this challenge at a level relevant to information process design and technology development. This paper describes the design science research method used to combine the sense of coherence, which is a core concept within the Antonosky salutogenic approach to health and well-being, with an established information infrastructure maturity framework, demonstrating the coalescence of 2 distinct conceptual perspectives on care delivery. This paper provides an approach to defining a positive and supportive health care experience and linking this to the capabilities of an information- and technology-enabled environment. Results This research delivers a methodology for describing the patient experience in a form relevant to information infrastructure design, articulating a pathway from information infrastructure to patient experience. It proposes that patient experience can be viewed pragmatically in terms of the established sense of coherence concept, with its ability to identify and guide resources to modulate a patient’s environmental stressors. This research establishes a framework for determining and optimizing the capability of a facility’s information infrastructure to support the sense of coherence defined by the experiences of its patients. Conclusions This groundbreaking research provides a framework for health care provider organizations to understand and assess the ability of their information infrastructure to support and improve the patient experience. The tool assists providers in defining their technology-dependent operational goals around patient experience and, consequently, in identifying the information capabilities needed to support these goals. The results demonstrate how a fundamental shift in thinking about the use of information infrastructure can transform the patient experience. This study details an approach to describing information infrastructure within an experience-oriented framework that enables the impact of technology on experience to be designed explicitly. The contribution to knowledge is a new perspective on modeling how information infrastructure can contribute to supportive health-promoting environments. Furthermore, it may significantly affect the design and deployment of future digital infrastructures in health care.
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Affiliation(s)
- Patricia Anne Helen Williams
- Flinders-Cisco Digital Health Design Lab, Flinders Digital Health Research Centre, College of Science and Engineering, Flinders University, Tonsley CampusGPO Box 2100, Adelaide, SA, AU
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Uren AD, Cotterill N, Abrams P, Catto JWF, Patel B, McGrath J, Ahmed I, Rowe E. The development of the Cystectomy-Pathway Assessment Tool (C-PAT): a concise tool to assess the quality of care in the cystectomy pathway. BJU Int 2021; 129:708-717. [PMID: 34218507 DOI: 10.1111/bju.15539] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 06/01/2021] [Accepted: 07/01/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To develop and test the psychometric properties of a concise, patient-reported questionnaire, designed to assess key aspects of the radical cystectomy (RC) patient pathway that are important to both patients and clinicians. PATIENTS AND METHODS Draft items were developed by a consultation with a 13-member expert clinical panel, and the in-depth qualitative analysis of 14 semi-structured interviews with patients who had received RC within the previous 18 months. A further nine cognitive interviews with patients refined the items and ensured they were easy to complete. Pilot testing in 122 patients recruited from five hospitals in England tested the properties of validity and reliability of the resulting 17-item questionnaire. RESULTS Patients and clinicians identified the following aspects as important for the delivery of quality patient care. These included timely referral and initial test results; an explanation of risk/benefits of treatment; access to a cancer nurse specialist; training and support in stoma management; timely surgery, surgical complications, and timely follow-up. Pilot testing showed missing data was low (≤3% for all items), and between 73% and 89% of the responses to items were the most positive about their care (indicating ceiling effects). Five items were identified using factor analysis as being statistically related (Cronbach's α 0.76, intraclass correlation coefficient test-retest reliability of 0.95) and formed the scored part of the tool 'care and support', scored 0-16. There was insufficient evidence at this stage to show the tool was capable of measuring differences between cancer centres. CONCLUSION We have developed a questionnaire that captures aspects of quality of care within the RC patient pathway. The results support the validity and reliability of the 17-item Cystectomy-Pathway Assessment Tool (C-PAT). We envisage the tool can be the basis for audit of the patient reported assessment of the quality of care for individual cancer centres.
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Affiliation(s)
- Alan D Uren
- Department of Urology, Bristol Urological Institute, Southmead Hospital, Bristol, UK
| | - Nikki Cotterill
- Department of Nursing and Midwifery, Faculty of Health and Applied Sciences, University of the West of England, Bristol and the Bristol Urological Institute, Bristol, UK
| | - Paul Abrams
- Department of Urology, Bristol Urological Institute, Southmead Hospital, Bristol, UK
| | - James W F Catto
- Academic Urology Unit, University of Sheffield, Sheffield, UK.,Department of Urology, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - Biral Patel
- Department of Urology, Gloucestershire Hospitals NHS Foundation Trust UK, Cheltenham, UK
| | | | - Iram Ahmed
- Medway Maritime Hospital, Medway NHS Foundation Trust, Gillingham, UK
| | - Edward Rowe
- Department of Urology, Bristol Urological Institute, Southmead Hospital, Bristol, UK
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Aquilina T, Thompson SM, Metcalfe KHM, Hughes H, Sinclair L, Batt F. The involvement of older inpatients in medical student education. Eur Geriatr Med 2018; 9:77-82. [PMID: 29430268 PMCID: PMC5797205 DOI: 10.1007/s41999-017-0023-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 12/26/2017] [Indexed: 11/26/2022]
Abstract
Objectives To examine older inpatients’ experiences with medical student education, their views on future interactions, and to seek their opinion on the most important curricular topics related to geriatric medicine. Methods The study involved 112 non-confused inpatients older than 65 years of age, who completed a uniformed questionnaire on the day of their discharge from a teaching hospital. Results The mean age was 81 years, with equal number of male and female participants. 57% interacted with the students during their admission, the majority being interviewed and examined. Almost all (92%) of these patients described their experience as positive, some described it as time-consuming (23%), repetitive (19%) and tiresome (9%). 92% of all participants agreed that the older patients should be part of medical students’ education. Dementia, cardiac conditions, cancer, arthritis, isolation/loneliness were highlighted as the most important topics to teach medical students related to geriatric medicine, while patience and listening were listed as important skills. They suggested practical, easily implemented advice for the improvement of the interaction between students and older patients; including allowing more time for interactions and for students to speak louder. Conclusions Older patients felt positively about their interactions with medical students, and believed that older patients should be involved in medical student education. As well as medical conditions such as dementia, cardiac disease and cancer, these patients highlighted isolation and loneliness as important topics for undergraduate geriatric medical education, implying that students should learn about broader aspects of older patients’ health and wellbeing.
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Affiliation(s)
- T Aquilina
- Oxford University Medical School, Oxford, UK
| | - S M Thompson
- Departments of General (Internal) Medicine and Geratology, John Radcliffe Hospital, Oxford, UK.
| | | | - H Hughes
- Oxford University Medical School, Oxford, UK
| | - L Sinclair
- Oxford University Medical School, Oxford, UK
| | - F Batt
- Departments of General (Internal) Medicine and Geratology, John Radcliffe Hospital, Oxford, UK
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Carletti G, Soriani N, Mattiazzi M, Gregori D. A Social Network Approach to the Estimation of Perceived Quality of Health Care. Open Nurs J 2017; 11:219-231. [PMID: 29238425 PMCID: PMC5712639 DOI: 10.2174/1874434601711010219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 05/15/2017] [Accepted: 07/07/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Measuring service quality aids health care providers to recognize specific and unmet needs of patients. Nevertheless, perceived quality of health care services (PQC) is often investigated with inadequate techniques which may lead to biased results. OBJECTIVE The aim of the present study is to develop a proof-of-concept for estimating the PQC using the scale-up estimator, with reference to a concrete assessment in patients of a major Oncology Hospital in Veneto (IOV). Results have then been compared with those collected by the Customer Relations Office (CRO) after the annual survey conducted with traditional questionnaire based techniques. MATERIAL AND METHODS Seven hundred and eighty-three sets consisting of two questionnaires were handed out to IOV patients between 26 and 28 November 2012. The first questionnaire was the CRO annual one composed by 15 direct questions about the perception of quality satisfaction rate using a Likert scale. The second questionnaire was the scale-up (NSUM) one, composed by 20 indirect questions, 5 of which were reproducing the main target of CRO for estimating PQC. RESULTS The comparisons made over 299 sets of questionnaires showed differences between the two techniques. Network Scale-Up Method (NSUM) questionnaire seems to be able to produce lower estimates of PQC with respect to the CRO annual questionnaire. In some cases, the NSUM showed dissatisfaction rates which are 20-fold higher respect to CRO. CONCLUSION NSUM could be a promising method for assessing the perceived quality of care.
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Affiliation(s)
- Giulia Carletti
- Department of Radiotherapy and Molecular Medicine, Istituto Oncologico Veneto, Padova, Italy
| | - Nicola Soriani
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiology, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | | | - Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiology, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
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Williams KE, Sansoni J, Morris D, Thompson C. A Delphi study to develop indicators of cancer patient experience for quality improvement. Support Care Cancer 2017; 26:129-138. [PMID: 28711975 DOI: 10.1007/s00520-017-3823-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Accepted: 07/03/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE The purpose of this study was to develop prioritised indicators to measure cancer patient experience and thus guide quality improvement in the delivery of patient care. METHODS A Delphi study, consisting of two surveys and three workshops, was employed to gather expert opinions on the most important indicators to measure. Survey participants were 149 health professionals, academics/technical experts and consumers. The first survey was based on a literature review which identified 105 elements of care within 14 domains of patient experience. These were rated on a 7-point Likert scale, with '1' representing high importance. Elements with mean ratings between 1.0 and 2.0 were retained for the second survey. The 43 least-important elements were omitted, four elements were revised and nine new elements added. Consensus was defined as at least 70% of participants rating an element '1' or '2'. Multivariate and cluster analyses were used to develop 20 draft indicators, which were presented to 51 experts to refine and prioritise at the three workshops. RESULTS All elements in the second survey were rated '1' or '2' by 81% of participants. Workshop participants agreed strongly on the four most important indicators: coordinated care, access to care, timeliness of the first treatment, and communication. Other indicators considered highly important were follow-up care for survivors; timeliness of diagnosis; information relating to side effects, pain and medication; comprehensibility of information provided to patients; and needs assessment. CONCLUSIONS Experts identified priorities with a high level of consensus, providing a rigorous foundation for developing prioritised indicators of quality in cancer patient experience.
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Affiliation(s)
- Kathryn E Williams
- Centre for Health Service Development, Australian Health Services Research Institute (AHSRI), University of Wollongong, Wollongong, New South Wales, 2522, Australia.
| | - Janet Sansoni
- Centre for Health Service Development, Australian Health Services Research Institute (AHSRI), University of Wollongong, Wollongong, New South Wales, 2522, Australia
| | - Darcy Morris
- Centre for Health Service Development, Australian Health Services Research Institute (AHSRI), University of Wollongong, Wollongong, New South Wales, 2522, Australia
| | - Cristina Thompson
- Centre for Health Service Development, Australian Health Services Research Institute (AHSRI), University of Wollongong, Wollongong, New South Wales, 2522, Australia
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Cunningham M, Wells M. Qualitative analysis of 6961 free-text comments from the first National Cancer Patient Experience Survey in Scotland. BMJ Open 2017; 7:e015726. [PMID: 28619780 PMCID: PMC5734250 DOI: 10.1136/bmjopen-2016-015726] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 02/27/2017] [Accepted: 03/20/2017] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To analyse free-text responses from the first Scottish Cancer Patient Experience Survey (SCPES) to understand patients' experiences of care, identify valued aspects and areas for improvement. DESIGN Inductive thematic analysis of seven free-text comment boxes covering all stages of the cancer experience, from a national cohort survey. SETTING AND PARTICIPANTS Adult cancer patients diagnosed across all Health Boards in Scotland between July 2013 and March 2014, and who had an inpatient stay or hospital visit between January and September 2014. 2663 respondents (of n=4835 survey respondents) provided 6961 free-text comments. MAIN OUTCOME MEASURES Positive and negative themes of patients' experiences. Differences in the proportion of positive to negative comments by demographics. METHODS Data were analysed as follows: (1) comments were initially categorised at a high level (eg, positive, negative, miscellaneous, etc); (2) inductive codes were derived and applied to all relevant comments; (3) codes sharing similar meaning were amalgamated into subthemes, and code frequencies were measured; (4) subthemes were mapped into overarching themes; (5) difference in the proportion of positive to negative comments by demographics were analysed using χ2 tests. RESULTS Participants made more positive than negative comments (1:0.78). Analysis highlighted the importance to patients of Feeling that Individual Needs Are Met and Feeling Confident Within the System. Comments also provided insight into how Processes and Structures within the system of care can negatively impact on patients' experience. Particular issues were identified with care experiences in the lead-up to diagnosis. CONCLUSIONS This analysis provides a detailed understanding of patients' cancer care experiences, therefore indicating what aspects matter in those experiences. Although the majority of comments were positive, there were a significant number of negative comments, especially about the lead-up to diagnosis. Comments suggest patients would value greater integration of care from services involved in their treatment for cancer.
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Affiliation(s)
| | - Mary Wells
- NMAHP Research Unit, University of Stirling, Stirling, UK
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