Burton-Chase Allison M, Parker Wendy M, Polivka Katrina M, Gritz Ellen R, Amos Christopher I, Lu Karen H, Lynch Patrick M, Rodriguez-Bigas Miguel A, Nancy You Y, Peterson Susan K
Department of Population Health Sciences, Albany College of Pharmacy and Health Sciences, Albany, New York.
Division of Health Promotion & Behavioral Science, University of Texas Health Science Center-Houston School of Public Health, Houston, Texas.
Cancer Med. 2017 Mar;6(3):698-707. doi: 10.1002/cam4.1033. Epub 2017 Feb 17.
This study evaluated provider satisfaction in a sample of colorectal cancer (CRC) survivors with and without Lynch syndrome (LS). Participants were case-case-matched CRC survivors with (n = 75) or without (n = 75) LS (mean age of 55; range: 27-93). Participants completed a mailed questionnaire assessing demographics, clinical characteristics, healthcare utilization, psychosocial variables, and provider satisfaction. LS CRC survivors reported lower provider satisfaction scores on three subscales of the Primary Care Assessment Survey: communication (78.14 vs. 83.96; P < 0.05), interpersonal treatment (78.58 vs. 85.30; P < 0.05), and knowledge of the patient (60.34 vs. 69.86; P < 0.01). Among LS CRC survivors, predictors for mean communication and trust subscale scores were location of treatment and socioeconomic status. Higher mean depression scores also were associated with trust, while social support predicted higher satisfaction with communication. Sporadic CRC survivor satisfaction is driven largely by age (communication, interpersonal treatment) and patient anxiety (communication), while seeing a provider more often was associated with increased satisfaction with knowledge of the patient. LS CRC survivors reported lower levels of provider satisfaction than sporadic CRC survivors. LS survivors who received care at The University of Texas MD Anderson Cancer Center, a comprehensive cancer center (CCC), reported higher satisfaction than those receiving care at other institutions. Depressive symptoms and socioeconomic status may impact provider satisfaction ratings. Exploration of other potential predictors of provider satisfaction should be examined in this population. Additionally, further research is needed to examine the potential impact of provider satisfaction on adherence to medical recommendations in LS CRC survivors, particularly those being treated outside of CCCs.
本研究评估了患有和未患有林奇综合征(LS)的结直肠癌(CRC)幸存者样本中医疗服务提供者的满意度。参与者为病例 - 病例匹配的CRC幸存者,其中75例患有LS,75例未患有LS(平均年龄55岁;范围:27 - 93岁)。参与者完成了一份邮寄问卷,评估人口统计学、临床特征、医疗保健利用情况、心理社会变量以及医疗服务提供者的满意度。LS CRC幸存者在初级保健评估调查的三个子量表上报告的医疗服务提供者满意度得分较低:沟通(78.14对83.96;P < 0.05)、人际治疗(78.58对85.30;P < 0.05)以及对患者的了解(60.34对69.86;P < 0.01)。在LS CRC幸存者中,平均沟通和信任子量表得分的预测因素是治疗地点和社会经济地位。较高的平均抑郁得分也与信任相关,而社会支持预示着对沟通的更高满意度。散发性CRC幸存者的满意度很大程度上由年龄(沟通、人际治疗)和患者焦虑(沟通)驱动,而更频繁地就诊与对患者了解方面的满意度增加相关。LS CRC幸存者报告的医疗服务提供者满意度水平低于散发性CRC幸存者。在德克萨斯大学MD安德森癌症中心(一个综合性癌症中心,CCC)接受治疗的LS幸存者报告的满意度高于在其他机构接受治疗的患者。抑郁症状和社会经济地位可能会影响医疗服务提供者满意度评级。应在该人群中探索医疗服务提供者满意度的其他潜在预测因素。此外,还需要进一步研究来检查医疗服务提供者满意度对LS CRC幸存者遵循医疗建议的潜在影响,特别是那些在CCC以外接受治疗的患者。