Wood Kelley C, Bertram Jessica J, Kendig Tiffany D, Pergolotti Mackenzi
ReVital Cancer Rehabilitation, Select Medical, Mechanicsburg, PA 17050, USA.
Outpatient Division, Baylor Scott and White Institute for Rehabilitation, Dallas, TX 76132, USA.
Healthcare (Basel). 2023 Jan 25;11(3):348. doi: 10.3390/healthcare11030348.
Understanding patient experience is key to optimize access and quality of outpatient cancer rehabilitation (physical or occupational therapy, PT/OT) services.
We performed a retrospective mixed-method analysis of rehabilitation medical record data to better understand patient experience and aspects of care that influenced experience. From the medical record, we extracted case characteristics, patient experience data (Net Promoter Survey, NPS) and patient-reported outcome (PRO) data. We categorized cases as 'promoters' (i.e., highly likely to recommend rehabilitation) or 'detractors', then calculated NPS score (-100 [worst] to 100 [best]). We identified key themes from NPS free-text comments using inductive content analysis, then used Pearson [] or Spearman [] correlation to explore relationships between NPS, characteristics, and PRO improvement.
Patients (n = 383) were 60.51 ± 12.02 years old, predominantly women with breast cancer (69.2%), and attended 14.23 ± 12.37 visits. Most were 'promoters' (92%); NPS score was 91.4. Patients described two experiences (themes) that influenced their likelihood to recommend rehabilitation: (1) feeling comfortable with the process and (2) observable improvement in health/functioning, and described attributes of clinic staff, environment and clinical care that influenced themes. Likelihood to recommend rehabilitation was associated with achieving the minimal clinical important difference on a PRO ( = 0.21, < 0.001) and cancer type ( = 0.10, < 0.001).
Patients who received specialized cancer PT/OT were highly likely to recommend rehabilitation. Feeling comfortable with the rehabilitation process and making observable improvements in health and/or functioning influenced likelihood to recommend. Rehabilitation providers should leverage the findings of this study optimize access to and quality of cancer rehab services.
了解患者体验是优化门诊癌症康复（物理治疗或职业治疗，PT/OT）服务的可及性和质量的关键。
我们对康复病历数据进行了回顾性混合方法分析，以更好地了解患者体验以及影响体验的护理方面。从病历中，我们提取了病例特征、患者体验数据（净推荐值调查，NPS）和患者报告结局（PRO）数据。我们将病例分为“推荐者”（即极有可能推荐康复治疗）或“贬损者”，然后计算NPS得分（-100[最差]至100[最佳]）。我们使用归纳性内容分析法从NPS自由文本评论中确定关键主题，然后使用Pearson[]或Spearman[]相关性分析来探讨NPS、特征和PRO改善之间的关系。
患者（n = 383）年龄为60.51±12.02岁，主要是乳腺癌女性患者（69.2%），就诊次数为14.23±12.37次。大多数是“推荐者”（92%）；NPS得分为91.4。患者描述了影响其推荐康复治疗可能性的两种体验（主题）：（1）对治疗过程感到舒适，（2）健康/功能有明显改善，并描述了影响这些主题的诊所工作人员、环境和临床护理的属性。推荐康复治疗的可能性与在PRO上达到最小临床重要差异相关（= 0.21，<0.001）以及癌症类型（= 0.10，<0.001）。
接受专门癌症PT/OT治疗的患者极有可能推荐康复治疗。对康复治疗过程感到舒适以及健康和/或功能有明显改善影响了推荐的可能性。康复治疗提供者应利用本研究的结果来优化癌症康复服务的可及性和质量。
