How do patients with colorectal cancer perceive treatment and care compared with the treating health care professionals?
BACKGROUND
Patient evaluations are widely used in quality assessment of health services. It is widely recognized that patients and professionals provide a different perspective on quality. However, the extent to which they differ and the conceptual areas in which they differ is not well understood.


OBJECTIVE
We sought to examine how well professional and patient assessments of hospital health care correspond.


METHODS
We undertook a prospective study in which information from a national clinical register was combined with questionnaires to patients, surgeons, and nurses. The study included 527 patients after surgery for colorectal cancer. The patients and their professionals assessed the same questions. For 336 patients, all questionnaires and register information were available. The response rate was 64%. The main measures were assessments of technical, interpersonal, and organizational aspects of care. Agreement was analyzed by kappa statistic, kappa, and McNemar's test.


RESULTS
Comparing assessments of technical surgical care kappa statistic demonstrated moderate-to-almost perfect agreement (0.35 <or= kappa <or= 0.95). Assessments of technical nursing care demonstrated slight agreement (0.19 <or= kappa <or= 0.26). Comparing answers to questions on interpersonal or organizational care, kappa statistic revealed only slight or no more agreement than expected by chance (-0.06 <or= kappa <or= 0.30). For several items, McNemar's test revealed a significant difference in the distribution of answers.


CONCLUSIONS
Within a Danish population undergoing treatment of colorectal cancer, there were significant differences in perceptions of care between patients and health professionals. In particular, health professionals and readers of reports on patient evaluations ought to remember that patients' perspective is just one source of information in assessment of hospital health care.
Mathiesen
Tanja Pagh
TP
Research Centre for Prevention and Health, Glostrup University Hospital, Glostrup, Denmark. ole_tanja@wanadoo.dk
Willaing
Ingrid
I
Freil
Morten
M
Jørgensen
Torben
T
Andreasen
Anne Helms
AH
Ladelund
Steen
S
Harling
Henrik
H
D000368:Aged; D001291:Attitude of Health Personnel; D015179:Colorectal Neoplasms / Q000628:therapy; D003718:Denmark; D005260:Female; D017144:Focus Groups; D019538:Health Care Surveys; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D011787:Quality of Health Care