Thames Cancer Registry, King's College London, UK.
J Eval Clin Pract. 2010 Aug;16(4):776-83. doi: 10.1111/j.1365-2753.2009.01192.x. Epub 2010 Jun 10.
National surveys of patients' experiences of English cancer services found improvements between 2000 and 2004, particularly in the areas of information, communication and trust in professionals.
We assessed the potential such surveys might have to stimulate service improvements by comparing their inclusion criteria, sampling and timing and by investigating how representative they were of patients registered with cancer in South East England. Where hospital trusts had data from 50 patients with the same cancer, we determined whether national improvements in six key areas held at hospital trust level.
Data were extracted from the two national surveys and from the Thames Cancer Registry.
The 2000 survey achieved a higher response rate, included a larger number of hospital trusts, and a wider range of cancer sites, but a lower proportion with lung cancer. Each survey sampled patients at different points following diagnosis, with a year elapsing between data collection and reporting. Compared with cancer registry data, breast cancer patients appeared most well-represented. Only three hospital trusts had sufficiently large samples to allow comparison over time. We found no change in experience in three of the key areas, but a significant decline from previously high scores in two.
To provide information useful for quality improvement future surveys will need to sample larger numbers of patients from most hospital trusts, including patients with less common cancers or receiving palliative care. Surveys should also sample patients at a consistent time after diagnosis and feedback results more rapidly to services.
对患者体验英语癌症服务的全国性调查发现,2000 年至 2004 年间,服务质量有所改善,尤其是在信息提供、医患沟通和对专业人员的信任等方面。
我们通过比较纳入标准、抽样和时间安排,以及调查它们在多大程度上代表了英格兰东南部注册的癌症患者,评估这些调查在刺激服务改善方面的潜力。如果医院信托机构有 50 名同一种癌症患者的数据,我们就会确定在医院信托机构层面,六个关键领域的国家改善情况是否存在。
数据取自于两次全国性调查和泰晤士癌症登记处。
2000 年的调查获得了更高的回复率,纳入了更多的医院信托机构和更多种类的癌症部位,但肺癌患者的比例较低。每项调查都在诊断后不同的时间点对患者进行抽样,数据收集和报告之间相隔一年。与癌症登记处的数据相比,乳腺癌患者的代表性似乎最强。只有三家医院信托机构的样本量足够大,可以进行时间上的比较。我们发现三个关键领域的体验没有变化,但其中两个领域的分数从之前的高分显著下降。
为了提供对质量改进有用的信息,未来的调查将需要从大多数医院信托机构中抽取更多数量的患者样本,包括较少见癌症或接受姑息治疗的患者。调查还应在诊断后相对一致的时间对患者进行抽样,并更迅速地向服务部门反馈结果。