title: Patient-reported quality of care and pain severity in cancer.
abstract: OBJECTIVE
  Despite treatment availability, many cancer patients experience severe pain. Although patient assessments of care are increasingly employed to evaluate quality of care, little is known about its association with cancer symptom burden. The objective of our study was to examine the association between patient-reported quality of care and pain severity in a nationally representative cohort of cancer patients.
  
  
  METHODS
  Quality of care was measured in three domains: physician communication, care coordination/responsiveness, and nursing care. Quality scores were dichotomized as optimal versus nonoptimal. Pain was measured on a scale of 0 (least) to 100 (worst). We utilized multivariable linear regression to examine the association between patient-reported quality of care and pain severity.
  
  
  RESULTS
  The analytic sample included 2,746 individuals. Fifty and 54% of patients, respectively, rated physician communication and care coordination/responsiveness as nonoptimal; 28% rated nursing care as nonoptimal. In adjusted models, rating physician communication as nonoptimal (versus optimal) was associated with a 1.8-point higher pain severity (p = 0.018), and rating care coordination/responsiveness as nonoptimal was associated with a 2.2-point higher pain severity (p = 0.006).
  
  
  CONCLUSIONS
  Patient-reported quality of care was significantly associated with pain severity, although the differences were small. Interventions targeting physician communication and care coordination/responsiveness may result in improved pain control for some patients.
authors: VA Ann Arbor Center for Clinical Management Research,Ann Arbor,Michigan.
authors: Kathryn A
authors: KA
authors: Martinez
authors: Johns Hopkins University School of Medicine,Division of General Internal Medicine,Baltimore,Maryland.
authors: Claire F
authors: CF
authors: Snyder
authors: WellPoint,Thousand Oaks,California.
authors: Jennifer L
authors: JL
authors: Malin
authors: Johns Hopkins Bloomberg School of Public Health,Department of Health Policy and Management,Baltimore,Maryland.
authors: Sydney M
authors: SM
authors: Dy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000523:psychology; D017063:Outcome Assessment, Health Care; D010146:Pain / Q000188:drug therapy / Q000523:psychology*; D059408:Pain Management / Q000379:methods / Q000592:standards*; D017060:Patient Satisfaction; D011787:Quality of Health Care; D011795:Surveys and Questionnaires
keywords: Cancer pain; Pain management; Patient satisfaction; Patient-reported outcomes; Quality of care