title: Satisfaction with care: an independent outcome measure in surgical oncology.
abstract: BACKGROUND
  Outcomes for treatment for upper gastrointestinal cancer traditionally include procedure-related morbidity and mortality and long-term survival. Patient-reported outcomes, such as quality of life (QOL) and satisfaction measures, add to standard end points, but associations between these factors are not fully understood. This study examined how patient satisfaction related to surgical morbidity, treatment type, and QOL outcomes after inpatient treatment for upper gastrointestinal cancer.
  
  
  METHODS
  Consecutive patients who had completed treatment in one unit were invited to participate in this study and complete the European Organization for Research and Treatment of Cancer QLQ-PATSAT32 and QLQ-C30 questionnaires within 2 months of discharge. Regression analyses examined relationships between satisfaction and surgical morbidity (major complications and type of treatment) and between satisfaction and QOL variables, adjusting for age and sex.
  
  
  RESULTS
  During the study, 181 patients were treated, 162 were eligible, and 139 returned both questionnaires (response rate, 86%). Of the study sample, the treatment outcome was potential cure in 105 (67 esophagectomy and 38 D2 gastrectomy), and 34 received palliative treatment. Thirty-seven patients (27%) had major complications. Patients who received palliative treatment reported satisfaction and QOL scores similar to those of patients who received curative treatment. However, patients who experienced major morbidity reported significantly worse QOL than those without morbidity (P<.01). Satisfaction scores were the same in patients with or without complications. There were no associations between satisfaction and QOL scores (r<.34).
  
  
  CONCLUSIONS
  Patient satisfaction with hospital care is independent of morbidity, treatment type, and QOL outcomes. It may be used to feed back information to providers of health care to improve patients' experiences of treatment.
authors.affiliation: Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol Royal Infirmary, BS8 2PR, United Kingdom.
authors.forename: Kerry N L
authors.initials: KN
authors.lastname: Avery
authors.forename: Chris
authors.initials: C
authors.lastname: Metcalfe
authors.forename: Joanna
authors.initials: J
authors.lastname: Nicklin
authors.forename: C Paul
authors.initials: CP
authors.lastname: Barham
authors.forename: Derek
authors.initials: D
authors.lastname: Alderson
authors.forename: Jenny L
authors.initials: JL
authors.lastname: Donovan
authors.forename: Jane M
authors.initials: JM
authors.lastname: Blazeby
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004938:Esophageal Neoplasms / Q000523:psychology / Q000601:surgery*; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D008297:Male; D008495:Medical Oncology; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000592:standards*; D017060:Patient Satisfaction; D011787:Quality of Health Care; D011788:Quality of Life; D013274:Stomach Neoplasms / Q000523:psychology / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome