Department of Medicine, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA 19104-2676, USA.
Med Decis Making. 2010 Mar-Apr;30(2):234-45. doi: 10.1177/0272989X09342753. Epub 2009 Aug 12.
Patients' assessment of satisfaction with care, quality of care, and outcomes has become a central issue in patient-centered prostate cancer (PCa) care. We sought to analyze the association between patient-reported satisfaction with care and health-related quality of life (HRQoL) in newly diagnosed PCa patients.
Prospective cohort design was used to recruit 590 newly diagnosed PCa patients from an urban academic hospital and a VA hospital. Participants completed satisfaction with care (CSQ-8) and HRQoL (SF-36 and UCLA-PCI) surveys prior to treatment and at 3, 6, 12, and 24 months' follow-up. Cross-lagged analysis was used to ascertain the causal direction between satisfaction with care and HRQoL. Propensity scores were used to adjust for potential selection bias between treatment groups. Linear mixed models were used to analyze the association between satisfaction with care, process of care (treatment), and outcomes (generic and prostate-specific HRQoL) after adjusting for covariates.
Cross-lagged correlation results are consistent with a cause-effect association between HRQoL and satisfaction with care. After controlling for clinical and demographic covariates, radical prostatectomy (RP) treatment was associated with higher satisfaction with care (odds ratio [OR], 7.9; P = 0.043). Improved generic and prostate-specific HRQoL were associated with higher satisfaction with care, after adjusting for demographic and clinical covariates.
Satisfaction with care appears to be associated with process of care and outcomes of care. Assessment of satisfaction with care is useful for evaluating the quality of PCa care. Satisfaction with care is an important arena in cancer outcomes research, whose full potential remains unexploited.
患者对医疗护理满意度、护理质量和治疗效果的评价已成为以患者为中心的前列腺癌（PCa）护理的核心问题。本研究旨在分析新诊断 PCa 患者的护理满意度与健康相关生活质量（HRQoL）之间的关系。
采用前瞻性队列设计，从一所城市学术医院和一家退伍军人事务医院招募了 590 例新诊断的 PCa 患者。参与者在治疗前和治疗后 3、6、12 和 24 个月时完成了护理满意度（CSQ-8）和 HRQoL（SF-36 和 UCLA-PCI）调查。交叉滞后分析用于确定护理满意度和 HRQoL 之间的因果关系。使用倾向评分调整治疗组之间的潜在选择偏倚。线性混合模型用于分析调整协变量后护理满意度、护理过程（治疗）和结果（通用和前列腺特异性 HRQoL）之间的关系。
交叉滞后相关结果与 HRQoL 和护理满意度之间的因果关系一致。在控制了临床和人口统计学协变量后，根治性前列腺切除术（RP）治疗与更高的护理满意度相关（比值比 [OR]，7.9；P = 0.043）。在调整了人口统计学和临床协变量后，通用和前列腺特异性 HRQoL 的改善与更高的护理满意度相关。
护理满意度似乎与护理过程和护理结果有关。评估护理满意度有助于评估 PCa 护理质量。护理满意度是癌症结局研究的一个重要领域，其潜力尚未得到充分利用。
