title: The first step in ensuring patient-centred quality of care: ask the patient.
abstract: Health providers may not be aware of their patients' needs or preferences, and patients reluctant to raise their concerns. Consequently, the first step in ensuring quality of care is to ask the patient about the care that they would like. A cross-sectional sample of 244 medical oncology outpatients were surveyed about provider-asking behaviours across six dimensions of patient-centred care defined by the Institute of Medicine. Specifically, were patients asked by clinic staff at the treatment centre about their physical and emotional symptoms, information needs to enable decision-making, preferences for involvement in decision-making, involvement of family and friends, and appointment scheduling. Patients were significantly (Cochran's χ2(9) = 122.541, P < 0.001) less likely to be asked about emotional symptoms (35% infrequently asked), preferences for the involvement of family and friends (25% infrequently asked), and preferences for involvement in medical decision-making (23% infrequently asked). Only a minority of patients were infrequently asked about their treatment-related information needs (8%), physical symptoms (13% pain, 14% fatigue) and preferences for appointment scheduling (13%). Younger age, not Australian born and greater educational qualifications were associated with being infrequently asked. Improvements to care delivery can be made if clinic staff were to more regularly elicit patient's emotional symptoms, and their preferences for the involvement of family/friends and participation in medical decision-making.
authors.affiliation: Health Behaviour Research Group, Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute, Level 4, Hunter Medical Research Institute, Callaghan, NSW, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Zucca
authors.affiliation: Health Behaviour Research Group, Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute, Level 4, Hunter Medical Research Institute, Callaghan, NSW, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Sanson-Fisher
authors.affiliation: Health Behaviour Research Group, Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute, Level 4, Hunter Medical Research Institute, Callaghan, NSW, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Waller
authors.affiliation: Health Behaviour Research Group, Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute, Level 4, Hunter Medical Research Institute, Callaghan, NSW, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Carey
authors.affiliation: Department of Medical Oncology, Royal Hobart Hospital, Hobart, TAS, Australia.
authors.forename: D
authors.initials: D
authors.lastname: Boadle
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000592:standards; D001315:Australia; D002173:Cancer Care Facilities; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D010358:Patient Participation; D057240:Patient Preference; D018802:Patient-Centered Care / Q000592:standards*; D011787:Quality of Health Care / Q000592:standards*; D012944:Social Support; D055815:Young Adult
keywords: cancer; medical oncology; patient-centred care; quality of care