VA Tennessee Valley Geriatric Research, Education and Clinical Care, Nashville, USA.
BJU Int. 2013 Feb;111(2):213-20. doi: 10.1111/j.1464-410X.2012.11423.x. Epub 2012 Aug 29.
To evaluate the impact of demographic, clinical, treatment and patient-reported parameters on satisfaction with prostate cancer care. Despite the significant worldwide impact of prostate cancer, few data are available specifically addressing satisfaction with treatment-related care.
CaPSURE comprises participants from 40 US sites who were monitored during and after their treatment course. Participants who were diagnosed with clinically localized prostate cancer after 1999 underwent radical prostatectomy, radiation therapy or primary androgen deprivation, and those who also completed the satisfaction questionnaire within 2 years of treatment were included in the present study. Satisfaction was measured using a validated instrument that assesses contact with providers, confidence in providers, communication skills, humanness and overall satisfaction. Multivariable linear regression analysis were performed to evaluate the independent relationships between demographic, clinical, treatment and patient-reported parameters and satisfaction.
Of the 3056 participants, 1927 (63%) were treated with radical prostatectomy, 843 (28%) were treated with radiation therapy and 286 (9%) were treated with primary androgen deprivation. Multivariable analysis showed that multiple patient-reported factors were independently associated with satisfaction, whereas clinical, demographic and treatment parameters were not. Baseline health-related quality of life, measured by the 36-item short-form health survey, baseline fear of cancer recurrence (all P < 0.01) and declines in the sexual (P = 0.03), urinary (P < 0.01) and bowel (P = 0.02) function domains of the University of California Los Angeles Prostate Cancer Index were all independently associated with satisfaction. Patient-reported outcomes were more strongly associated with satisfaction in the low-risk subgroup.
Patient-reported factors such as health-related quality of life and fear of cancer recurrence are independently associated with satisfaction with care. Pretreatment parameters should be used to identify populations at-risk for dissatisfaction to allow for intervention and/or incorporation into treatment decision-making.
评估人口统计学、临床、治疗和患者报告参数对前列腺癌治疗满意度的影响。尽管前列腺癌在全球范围内具有重要影响，但关于治疗相关护理满意度的具体数据很少。
CaPSURE 包括来自 40 个美国站点的参与者，他们在治疗过程中和治疗后接受监测。1999 年后被诊断为临床局限性前列腺癌的参与者接受了根治性前列腺切除术、放射治疗或初始雄激素剥夺治疗，并且在治疗后 2 年内完成满意度问卷的患者也被纳入本研究。使用经过验证的工具评估满意度，该工具评估与提供者的接触、对提供者的信心、沟通技巧、人性化和总体满意度。进行多变量线性回归分析，以评估人口统计学、临床、治疗和患者报告参数与满意度之间的独立关系。
在 3056 名参与者中，1927 名（63%）接受根治性前列腺切除术治疗，843 名（28%）接受放射治疗，286 名（9%）接受初始雄激素剥夺治疗。多变量分析显示，多个患者报告因素与满意度独立相关，而临床、人口统计学和治疗参数则不相关。基线健康相关生活质量，由 36 项简短健康调查问卷测量，基线对癌症复发的恐惧（均 P < 0.01）以及性（P = 0.03）、尿（P < 0.01）和肠（P = 0.02）功能领域的下降与满意度独立相关。UCLA 前列腺癌指数的患者报告结果与满意度的相关性更强在低危亚组中。
健康相关生活质量和对癌症复发的恐惧等患者报告因素与护理满意度独立相关。应使用治疗前参数来识别不满意风险人群，以便进行干预和/或纳入治疗决策。
