title: Melanoma survivors at high risk of developing new primary disease: a qualitative examination of the factors that contribute to patient satisfaction with clinical care.
abstract: BACKGROUND
  Providing ongoing clinical care that adequately addresses patients' medical, psychosocial and information needs is challenging, particularly for patient groups at increased risk of developing life-threatening disease such as malignant melanoma. This study examined a model of clinical care developed by the High Risk Clinic (HRC) of the Sydney Melanoma Diagnostic Centre in relation to patient satisfaction.
  
  
  METHODS
  Semi-structured telephone interviews were conducted and analyzed using the framework of Miles and Huberman, and themes were organized using the qualitative software package, QSR NVivo8.
  
  
  RESULTS
  Twenty HRC patients participated in the study (nine men, 11 women; mean age 57.6 years, age range 34-74 years; response rate 91%). Satisfaction with clinical care at the HRC was high. Factors contributing to patient satisfaction included: rapid and regular access to physicians who were perceived by participants as experts, the development of confidence and trust in one's treating doctor, and a sense of being cared about and understood by one's healthcare team. Although one-third of the participants reported some inconveniences in attending the clinic, these were viewed as minor difficulties and not significant barriers to care. Formal psychological support was not sought or expected by participants, although many expressed long-standing melanoma-related fears and concerns.
  
  
  CONCLUSIONS
  Accessible, expert medical attention, delivered in a patient-centered manner was integral to melanoma survivors' satisfaction with clinical management. Appropriate referrals to psychological support may further increase satisfaction with clinical care.
authors: School of Women's and Children's Health, UNSW Medicine, The University of New South Wales, Kensington, 2052, NSW, Australia.
authors: J K
authors: JK
authors: McLoone
authors: K J
authors: KJ
authors: Watts
authors: S W
authors: SW
authors: Menzies
authors: K
authors: K
authors: Barlow-Stewart
authors: G J
authors: GJ
authors: Mann
authors: N A
authors: NA
authors: Kasparian
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000523:psychology* / Q000628:therapy; D008875:Middle Aged; D020380:Needs Assessment; D017060:Patient Satisfaction; D012306:Risk; D012878:Skin Neoplasms / Q000523:psychology* / Q000628:therapy; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*
keywords: melanoma; patient satisfaction with care; psychosocial research; qualitative methods; unmet needs