Distribution and determinants of patient satisfaction in oncology: A review of the literature

Cancer is one of the leading causes of morbidity and mortality in the United States. It places considerable mental, physical, and emotional stress on patients and requires them to make major adjustments in many key areas of their lives. As a consequence, the demands on health care providers to satisfy the complex care needs of cancer patients increase manifold. Of late, patient satisfaction has been recognized as one of the key indicators of health care quality and is now being used by health care institutions for monitoring health care improvement programs, gaining accreditation, and marketing strategies. The patient satisfaction information is also being used to compare and benchmark hospitals, identify best-performance institutions, and discover areas in need of improvement. However, the existing literature on patient satisfaction with the quality of cancer care they receive is inconsistent and heterogeneous because of differences in study designs, questionnaires, study populations, and sample sizes. The aim of this review was therefore to systematically evaluate the available information on the distribution and determinants of patient satisfaction in oncology

Identifying strokes in Nigerian children with sickle cell disease as part of clinical trials: training curriculum for healthcare professionals in low-income settings

IntroductionNigeria has the highest proportion of children with sickle cell anemia (SCA) globally; without transcranial Doppler screening and ongoing treatment (regular blood transfusions or hydroxyurea therapy), 10% will have a stroke in childhood. In low-resource settings, training to recognize and prevent strokes in children with SCA is vital. A sustainable Sickle Cell Disease Stroke Prevention Teams program was established, as part of clinical trials, to address the need for stroke care in northern Nigeria. We describe our health professional stroke training curriculum and specific application to detect strokes in clinical trials in low-resource settings.MethodsChildren aged 5–12 and 2–16 years with SCA in northern Nigeria were enrolled in the SPRING and SPRINT primary and secondary stroke prevention trials, respectively. The primary outcome measure in both trials was a clinical stroke based on the World Health Organization definition. Non-neurologist physicians were trained in-person and via video lectures regarding stroke recognition, performing neurological examinations using the adapted Pediatric NIH Stroke Scale, and acute stroke care. Central stroke adjudicators, two pediatric neurologists, reviewed the case report forms and recorded videos of the neurological examinations.ResultsSix physicians completed the curriculum at three sites and were certified to detect strokes. Of 20 children with suspected stroke, 8 and 11 children had acute initial or acute recurrent strokes confirmed in the SPRING (N = 220) and SPRINT (N = 101) trials, respectively. The concordance rate between local stroke diagnoses and the central stroke adjudication process was 95% (19 of 20). One child presented with non-specific symptoms and hypertonia and was mislabeled locally as an acute stroke.DiscussionA curriculum to train healthcare providers in pediatric acute stroke recognition and care in a low-resource setting is feasible and sustainable. We successfully identified strategies for task shifting from a single pediatric neurologist in the region to multiple non-neurologist physicians

The relationship between perceived service quality and patient willingness to recommend at a national oncology hospital network

<p>Abstract</p> <p>Background</p> <p>"Willingness to recommend" questions are being increasingly used to measure and manage patient loyalty. Yet, there is little data in the literature correlating the "willingness to recommend" question with commonly used perceived service quality items in surveys to identify the key drivers of the optimal patient experience. We therefore evaluated the relationship between perceived service quality and subsequent single top box "willingness to recommend" scores among oncology patients.</p> <p>Methods</p> <p>A total of 2018 returning cancer patients treated at Cancer Treatment Centers of America^®(CTCA) responded to an internally developed service quality questionnaire, which covered the following dimensions: operations and services, treatment and care with a multidisciplinary team and patient endorsements. Items were measured on a 7-point Likert-type scale ranging from "completely dissatisfied" to "completely satisfied." Patient willingness to, "recommend this facility to friends and associates" was measured on an 11-point scale ranging from "not at all likely" to "extremely likely", which was subsequently dichotomized into two categories: top box response (10) versus all others (0-9). The relationship between perceived service quality and "willingness to recommend" was assessed via Kendall's tau b correlation and univariate and multivariate logistic regression.</p> <p>Results</p> <p>Of the 2018 patients, 959 were newly diagnosed while 1059 were previously treated. 902 were males and 1116 females. The mean age was 54.2 years and the most frequent diagnoses were breast (412), lung (294), prostate (260), colorectal (179) and pancreas (169). 1553 patients said they were "extremely likely" to recommend CTCA to friends and associates, resulting in 77% "top box" responses while 465 (23%) responded in all other categories. The key service quality drivers that were statistically significant in the final logistic model were "team helping you understand your medical condition", "staff genuinely caring for you as an individual", "whole person approach to patient care" and "CTCA medical oncologist."</p> <p>Conclusions</p> <p>In this multi-center study, we demonstrate the predictive significance of perceived service quality as it relates to patient willingness to recommend an oncology service provider. This study is unique in reporting on the role of perceived service quality as a predictor of patient willingness to recommend in a large sample of cancer patients.</p

Distribution and determinants of patient satisfaction in oncology with a focus on health related quality of life

<p>Abstract</p> <p>Background</p> <p>Cancer patients usually undergo extensive and debilitating treatments, which make quality of life (QoL) and patient satisfaction important health care assessment measures. However, very few studies have evaluated the relationship between QoL and patient satisfaction in oncology. We investigated the clinical, demographic and QoL factors associated with patient satisfaction in a large heterogeneous sample of cancer patients.</p> <p>Methods</p> <p>A cohort of 538 cancer patients treated at Cancer Treatment Centers of America^®(CTCA) was assessed. A patient satisfaction questionnaire developed in-house by CTCA was used. It covered the following dimensions of patient satisfaction: hospital operations and services, physicians and staff, and patient endorsements for themselves and others. QoL was assessed using the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (QLQ-C30). The clinical, demographic and QoL factors were evaluated for predictive significance using univariate and multivariate logistic regression.</p> <p>Results</p> <p>The mean age of our patient population was 54.1 years (SD = 10.5, range 17-86), with a slight preponderance of females (57.2%). Breast cancer (n = 124) and lung cancer (n = 101) were the most frequent cancer types. 481 (89.4%) patients were "very satisfied" with their overall experience. Age and several QoL function and symptom scales were predictive of overall patient satisfaction upon univariate analysis. In the multivariate modeling, only those with a score above the median on the fatigue measure (i.e. worse fatigue) had reduced odds of 0.28 of being very satisfied (p = 0.03).</p> <p>Conclusion</p> <p>Patient fatigue, as reported by the QoL fatigue scale, was an independent significant predictor of overall patient satisfaction. This finding argues for special attention and programs for cancer patients who report higher levels of fatigue given that fatigue is the most frequently reported symptom in cancer patients.</p

Factors influencing attitudes toward controversial research: Quantitatively disentangling the social from the scientific.

Factors influencing attitudes toward controversial research: Quantitatively disentangling the social from the scientific

Social factors and UFO reports: was the SARS-CoV-2 pandemic associated with an increase in UFO reporting?

The ongoing SARS-Cov-2 pandemic had many drastic effects upon society beyond the illness and death it caused. Pandemic mitigation measures disrupted and altered behaviors related to social mobility, significantly increasing the time spent at home compared to the pre-pandemic period. Further, it was well documented that social anxiety and stress increased at a population level. Early in the pandemic there was speculation in the popular media that reporting of paranormal phenomena (e.g., UFOs, ghosts, etc.) increased due to factors associated with the pandemic. Past research on UFO/UAP reporting has theorized that increases are triggered by social factors, and so the pandemic provided a natural experiment to test these claims. To measure UFO reports we utilized two public databases of UFO reports for sightings in the United States, provided by the National UFO Reporting Center and the Mutual UFO Network. To estimate the impact of the pandemic we utilized two measures, one for social mobility and one for pandemic/disease severity. Google Community Mobility Reports provided a metric of social mobility for people who use Google Maps on their cellular telephone (i.e., amount of time spent at work compared to home), which we aggregated to a state level to estimate time spent at home. Second, we used new weekly SARS-CoV-2 cases and deaths, both absolute counts and per capita, which can be considered to be an indirect measure of anxiety and stress. We find that UFO reports did increase in 2020 compared to 2019 (p&lt;0.001 for both databases); however, the level of UFO reporting had little to no association with the various pandemic-related measures, offering no support for hypothesized social factors that influence reporting. A complicating factor in UFO reporting is the start in 2019 of Starlink satellite launches. These launches include up to 60 small satellites at once, and so are very distinctive and often easily visible. As a result, many people report these as UFOs. We coded and removed these reports from the sighting databases, and the filtered data similarly have no association with the pandemic-related factors. Further, with Starlink reports removed, there was no increase in sightings in 2020 compared to 2019. Our results contribute to an understanding of large-scale factors that impact the reporting of paranormal events, especially timely given the renewed public and government focus on the UFO phenomenon today

Social factors and UFO reports: was the SARS-CoV-2 pandemic associated with an increase in UFO reporting?

The ongoing SARS-Cov-2 pandemic had many drastic effects upon society beyond the illness and death it caused. Pandemic mitigation measures disrupted and altered behaviors related to social mobility, significantly increasing the time spent at home compared to the pre-pandemic period. Further, it was well documented that social anxiety and stress increased at a population level. Early in the pandemic there was speculation in the popular media that reporting of paranormal phenomena (e.g., UFOs, ghosts, etc.) increased due to factors associated with the pandemic. Past research on UFO/UAP reporting has theorized that increases are triggered by social factors, and so the pandemic provided a natural experiment to test these claims. To measure UFO reports we utilized two public databases of UFO reports for sightings in the United States, provided by the National UFO Reporting Center and the Mutual UFO Network. To estimate the impact of the pandemic we utilized two measures, one for social mobility and one for pandemic/disease severity. Google Community Mobility Reports provided a metric of social mobility for people who use Google Maps on their cellular telephone (i.e., amount of time spent at work compared to home), which we aggregated to a state level to estimate time spent at home. Second, we used new weekly SARS-CoV-2 cases and deaths, both absolute counts and per capita, which can be considered to be an indirect measure of anxiety and stress. We find that UFO reports did increase in 2020 compared to 2019 (p&amp;lt;0.001 for both databases); however, the level of UFO reporting had little to no association with the various pandemic-related measures, offering no support for hypothesized social factors that influence reporting. A complicating factor in UFO reporting is the start in 2019 of Starlink satellite launches. These launches include up to 60 small satellites at once, and so are very distinctive and often easily visible. As a result, many people report these as UFOs. We coded and removed these reports from the sighting databases, and the filtered data similarly have no association with the pandemic-related factors. Further, with Starlink reports removed, there was no increase in sightings in 2020 compared to 2019. Our results contribute to an understanding of large-scale factors that impact the reporting of paranormal events, especially timely given the renewed public and government focus on the UFO phenomenon today.</p