Fradgley Elizabeth A, Bryant Jamie, Paul Christine L, Hall Alix E, Sanson-Fisher Robert W, Oldmeadow Christopher
University of Newcastle, Callaghan, New South Wales, Australia
University of Newcastle, Callaghan, New South Wales, Australia.
J Oncol Pract. 2016 Jun;12(6):e746-54. doi: 10.1200/JOP.2016.011023. Epub 2016 May 24.
This cross-sectional study assessed the association between oncology outpatients' quality improvement preferences and health-related quality of life (HRQoL). Implementation of specific initiatives preferred by patients with lower HRQoL may be a strategic approach to enhancing care for potentially vulnerable patients.
English-speaking adults were recruited from five outpatient chemotherapy clinics located in New South Wales, Australia. Using touch screen devices, participants selected up to 25 initiatives that would improve their experiences and completed the Functional Assessment of Cancer Therapy-General (FACT-G) survey. The logistic odds of selecting an initiative according to FACT-G scores were calculated to determine whether preferences were associated with HRQoL after controlling for potential confounders.
Of the 411 eligible outpatients approached to participate, 263 (64%) completed surveys. Commonly selected initiatives were up-to-date information on treatment and condition progress (19.8%), access to or information on financial assistance (18.3%), and reduced clinic wait times (17.5%). For those with relatively lower FACT-G scores, the adjusted odds of selecting five initiatives illustrated an increasing trend: convenient appointment scheduling systems (+23% [P = .002]), reduced wait times (+15% [P = .01]), information on medical emergencies (+14% [P = .04]), access to or information on financial assistance (+15% [P = .009]), help to maintain daily living activities (+18% [P = .007]).
Two areas of improvement were commonly selected: easily accessible health services and information and support for self-management. Although the results suggest an association between a few quality improvement preferences and HRQoL, a wider spectrum of patient characteristics must be considered when targeting quality improvement to patient subgroups.
本横断面研究评估了肿瘤门诊患者的质量改进偏好与健康相关生活质量(HRQoL)之间的关联。实施HRQoL较低的患者所偏好的特定举措可能是加强对潜在脆弱患者护理的一种战略方法。
从澳大利亚新南威尔士州的五家门诊化疗诊所招募说英语的成年人。参与者使用触摸屏设备选择多达25项可改善其就医体验的举措,并完成癌症治疗功能评估通用版(FACT-G)调查。计算根据FACT-G评分选择一项举措的逻辑比值,以确定在控制潜在混杂因素后偏好是否与HRQoL相关。
在邀请参与的411名符合条件的门诊患者中,263名(64%)完成了调查。常见的选择举措包括治疗和病情进展的最新信息(19.8%)、获得经济援助或相关信息(18.3%)以及缩短门诊等待时间(17.5%)。对于FACT-G评分相对较低的患者,选择五项举措的调整后比值呈现上升趋势:便捷的预约安排系统(增加23% [P = .002])、缩短等待时间(增加15% [P = .01])、医疗紧急情况信息(增加14% [P = .04])、获得经济援助或相关信息(增加15% [P = .009])、帮助维持日常生活活动(增加18% [P = .007])。
两个常见的改进领域被选中:易于获得的医疗服务以及自我管理的信息与支持。尽管结果表明一些质量改进偏好与HRQoL之间存在关联,但在针对患者亚组进行质量改进时,必须考虑更广泛的患者特征。