Relationship between patient satisfaction, quality of life and quality of care for cancer patients: a new approach for application in ambulatory specialised care.

Abstract Background IBD-care may be challenging and benefits from a multidisciplinary, cross-sectoral treatment approach and active patient involvement. However, occasionally there is a lack of patients′ empowerment and additionally, a necessity for the optimisation of physicians′ treatment is apparent. Furthermore, there is a deficiency in evidence regarding the effectiveness of structured care approaches (“managed care”) on patient-related outcomes (PROs). Therefore, our study aims to evaluate the potential of managed care programmes for IBD patients. Methods EASEIBD is a cross-border study conducted by IBD-DACH, an IBD working group in Germany (D), Austria (A) and Switzerland (Ch). Within the DACH-region, a cross-sectional survey of patients and physicians from IBD hospital-outpatient departments and gastroenterology practices was carried out. The questionnaire evaluated the effect of instruments and contextual factors of IBD-care with regard to quality of life (QoL). Additionally, the effects of “managed care” instruments were examined while considering centre-related structural characteristics. The analysis was performed using a multivariate multilevel regression model, controlled by various physician and patient characteristics. Results 2536 IBD-patients from 66 centres (643 IBD-patients/quarter; 31% hospital out-patient departments) were consecutively enrolled in EASEIBD (centres/IBD-pat.: D-52/1735; A-10/647; Ch-4/154). Overall, patient satisfaction (77-84%) (Fig. 1) as well as perceived quality of care (82-87%) (Fig. 2) was high and comparable in the descriptive analysis between German, Austrian and Swiss IBD-patients. Statistically significant differences were only found in single characteristics, e.g. in quality of life (EQ5D-VAS) (p=0.004) (Fig. 3). However, these do not appear clinically relevant with regard to the absolute values. In the entire DACH-region there were detectable effects of elements representing structural quality and assessments of the centres, with regard to the perceived quality of patient care (Fig. 4), whereby, in particular, a positive influence of web-based instruments (e.g. homepage) (p=0.040) and potential use of homecare calprotectin (0.046) had the most pronounced effect. Noteworthy, in Germany, the implementation of specialised IBD nurses was associated with a beneficial impact on patients′ QoL (0.027) when compared to the cumulative results from the entire DACH region (p=0.681). Conclusion Our study shows that the use of elements of managed care programmes resulted in a high process quality, which is evident from the reported high patient satisfaction and quality of care by IBD-patients in the entire DACH region, and qualifies this area as a suitable common study landscape.

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Prognostic significance of quality of life index in breast cancer

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.6135 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 6135-6135

Author(s):

D. Gupta ◽

J. F. Grutsch ◽

J. Granick ◽

R. Neelam ◽

P. G. Vashi ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Patient Satisfaction ◽

Cancer Patients ◽

Prognostic Significance ◽

Breast Cancer Patients ◽

Prognostic Information ◽

Life Index ◽

Quality Of Life Index

6135 Background: Quality of Life (QoL) is a multidimensional construct. There is extensive data showing that QoL tools measuring the activities of daily life provide prognostic information in cancer. However, similar information on QoL tools measuring patient satisfaction with their life is sparse. The Ferrans and Powers Quality of Life Index (QLI) is one such instrument. The goal of this study was to evaluate the statistical strength of association between QLI and survival in breast cancer patients undergoing care in a non-clinical trial setting. Methods: We examined a case series of 251 breast cancer patients treated at Cancer Treatment Centers of America between 04/01 and 11/04. QLI defines QoL in terms of satisfaction with the aspects of life that are important to the patient. QLI measures overall QoL and QoL in four major subscales: health and physical, social and economic, psychological and spiritual, and family. All scores range from 0 to 30 with higher scores indicating better QoL. Study patients were dichotomized into 2 groups based on median scores for all QoL subscales. Kaplan Meier method was used to calculate survival. Log-Rank test was used to study the equality of survival distributions. Results: Of 251 patients, 74 were newly diagnosed and 177 had prior treatment history. The median age was 48 years (range 25 - 74 years). 45 patients had stage I disease, 105 stage II, 38 stage III, and 32 stage IV. The table describes the median survival for all QLI subscales. Health and physical functioning subscale and QLI subtotal subscale were significantly associated with survival. Conclusions: This study shows that baseline levels of patient satisfaction with their QoL provide useful prognostic information in breast cancer. While these findings need to be evaluated further to ascertain which subscales of QoL have a role in predicting patients’ prognosis, they have important implications for patient stratification in clinical trials and may aid decision-making in clinical practice. [Table: see text] No significant financial relationships to disclose.

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Abstract 3849: Do cancer patients with better quality of life report higher satisfaction with the quality of care they receive

10.1158/1538-7445.am2014-3849 ◽

2014 ◽

Author(s):

Digant Gupta ◽

James F. Grutsch ◽

Mark Rodeghier ◽

Christopher G. Lis

Keyword(s):

Quality Of Life ◽

Quality Of Care ◽

Cancer Patients

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A randomized controlled trial (RCT) of long-term follow-up for early stage breast cancer comparing family physician to specialist care: A report of secondary outcomes

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.6003 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 6003-6003

Author(s):

E. Grunfeld ◽

J. Julian ◽

M. Levine ◽

K. Pritchard ◽

D. Coyle ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Patient Satisfaction ◽

Cancer Patients ◽

Family Physician ◽

Early Stage ◽

Breast Cancer Patients ◽

Secondary Outcomes

6003 Background: Breast cancer patients usually receive follow-up in specialist cancer clinics. We have reported that family physician follow-up of breast cancer patients is a safe and acceptable alternative to specialist follow-up as measured by the primary clinical outcome of the rate of serious clinical events (Grunfeld et al, JCO 2006;24(6)). We report here the secondary outcomes of this trial: quality of life domains, patient satisfaction and patients’ costs. Methods: Women with early stage breast cancer who had completed adjuvant therapy (patients may have continued on adjuvant hormonal therapy), who were disease free and between 9 and 15 months after diagnosis, were allocated to receive follow-up in a cancer clinic according to usual practice (CC arm) or follow-up from their own family physician (FP arm). For patients without recurrence, quality of life (QL) measured by the SF36, patient satisfaction, and patients’ costs were measured every 6 months. For patients with recurrence QL measured by the EORTC QLQ C-30 was measured at the time of recurrence. Results: 483 patients were allocated to the FP arm and 485 to the CC arm. Median follow-up was 3.5 years. There were no significant differences between groups on change scores for SF36 subscales to 24 months, or EORTC functional subscale scores at the time of recurrence. Patients’ costs of follow-up (travel costs, out-of-pocket expenses, and lost earnings) were significantly less to 24 months (p < 0.02) in the FP arm. Although costs were less between 36 and 48 months, these were not significant. Conclusions: Family physician follow-up of breast cancer patients does not have a negative impact on clinical or QL outcomes and is less costly for patients. No significant financial relationships to disclose.

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Defining the patient experience in medical oncology.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.30_suppl.167 ◽

2018 ◽

Vol 36 (30_suppl) ◽

pp. 167-167

Author(s):

Ashley Odai-Afotey ◽

Andrea Kliss ◽

Janet Hafler ◽

Tara B. Sanft

Keyword(s):

Quality Of Life ◽

Patient Satisfaction ◽

Quality Of Care ◽

Patient Experience ◽

Development Program ◽

Physician Communication ◽

Coordination Of Care ◽

Hospital Data ◽

Negative Factors

167 Background: The relationship between the physician and patient is directly associated with positive patient satisfaction. High patient satisfaction is associated with improved health outcomes, treatment adherence, and quality of life. The goal was to explore patients’ perceptions on their hospital experience, focusing on quality of care. Methods: A mixed-methods study design with a sample of 58 patients at Yale New Haven Hospital. Data were from patient interviews and observation of rounds. Results: Two themes emerged: patient experience and patient communication with physicians. Within patient experience positive factors identified were feeling attended to (45.9%), nurses (43.2%), staff (27.0%), doctors (27.0%), facility (10.8%) and coordination of care (8.1%). Negative factors were low quality of life (82.8%), lack of physician emotional support, attentiveness and availability (24.1%), and poor coordination of care (20.7%). Within physician communication positive factors included effectively engaging the patient (27.5%) and attending to patient needs (7.5%). Negative factors were nature of distilling information (17.5%), lack of coordination of care (15.0%), inadequate involvement of the patient and/or family (12.5%), use of medical jargon (10.0%), and inability to elicit patients’ perspective (7.5%). The quantitative data supported qualitative results of overall satisfaction with 72.4% of patients (n = 58) rating their experience as an ‘A’. Areas of dissatisfaction (an ‘A’ rating < 70% of time) included describing team member roles, explaining next steps in care or treatment to the patient and/or family, and meeting patients’ needs. Conclusions: Our findings, demonstrate that physician attentiveness or lack thereof defines the quality of patient experience, is an important theme in communication and that patients perceive their needs are not being fully addressed. Agreement in themes from mixed-method approach shows effectiveness of methods in exploring patients’ perceptions on quality of care. The study intends to inform clinical and operational practices physicians can incorporate into their patient relationships. These data are being used to design a faculty development program to address physician communication.

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