A longitudinal analysis of patient satisfaction with care and quality of life in ambulatory oncology based on the OUT-PATSAT35 questionnaire.
BACKGROUND
In the oncology setting, there has been increasing interest in evaluating treatment outcomes in terms of quality of life and patient satisfaction. The aim of our study was to investigate the determinants of patient satisfaction, especially the relationship between quality of life and satisfaction with care and their changes over time, in curative treatment of cancer outpatients.


METHODS
Patients undergoing ambulatory chemotherapy or radiotherapy in two centers in France were invited to complete the OUT-PATSAT35, at the beginning of treatment, at the end of treatment, and three months after treatment. This questionnaire evaluates patients' perception of doctors and nurses, as well as other aspects of care organization and services. Additionally, for each patient, socio-demographic and clinical characteristics, and self-reported quality of life data (EORTC QLQ-C30) were collected.


RESULTS
Of the 691 patients initially included, 561 answered the assessment at all three time points. By cross-sectional analysis, at the end of the treatment, patients who experienced a deterioration of their global health reported less satisfaction on most scales (p ≤ 0.001). Three months after treatment, the same patients had lower satisfaction scores only in the evaluation of doctors (p ≤ 0.002). Furthermore, longitudinal analysis showed a significant relationship between a deterioration in global health and a decrease in satisfaction with their doctor and, conversely, between an improvement in global health and an increase in satisfaction on the overall satisfaction scale. Global health at baseline was largely and significantly associated with all satisfaction scores measured at the following assessment time points (p < 0.0001). Younger age (<55 years), radiotherapy (versus chemotherapy) and head and neck cancer (versus other localizations) were clinical factors significantly associated with less satisfaction on most scales evaluating doctors.


CONCLUSIONS
Pre-treatment self-evaluated global health was found to be the major determinant of patient satisfaction with care. The subsequent deterioration of global health, during and after treatment, emphasized the decrease in satisfaction scores, mainly in the evaluation of doctors. Early initiatives aimed at improving the delivery of care in patients with poor health status should lead to improved perception of the quality of care received.
Clinical Research Department, EA 3181, Université de Franche Comté, Besançon 25030, France. nguyen_france@yahoo.fr.
Thanh Vân France
TV
Nguyen
Amélie
A
Anota
Anne
A
Brédart
Alain
A
Monnier
Jean-François
JF
Bosset
Mariette
M
Mercier
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D005602:France; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008390:Markov Chains; D008495:Medical Oncology / Q000379:methods*; D008875:Middle Aged; D009010:Monte Carlo Method; D015999:Multivariate Analysis; D009369:Neoplasms / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D017060:Patient Satisfaction; D010361:Patients / Q000523:psychology*; D010465:Perception; D010817:Physician-Patient Relations; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome