This review summarises current knowledge on the impact on patient satisfaction of initiatives undertaken to enhance the communication between doctors and their patients in oncology. Recent studies have assessed the effectiveness of different approaches aimed at improving doctor-patient communication in oncology. These have been assessed on outcomes related to the patient (e.g., anxiety, quality of life, medical knowledge, satisfaction) or to the doctor (e.g., communication behaviour, attitudes). Patient satisfaction has been recognised as a particularly relevant outcome, and a positive effect of recent initiatives to improve the interaction between cancer patients and their doctors on patient satisfaction has been suggested. To better respond to cancer patients' health care needs, various strategies focusing on doctor-patient communication have been developed. Addressing patients' overall needs and sharing complex information in an emotionally charged context and under time constraints is a daily challenge for the oncology clinician, resulting often in cancer patients' dissatisfaction. Recent interventions elaborated to facilitate doctor-patient communication in oncology focus on patients, such as handing out of videos or written preparatory information; on doctors, such as patients' self-rating feedback to doctors or communication skills trainings; or on both, such as the audiotaping of the consultation or the provision of decision aids. Although these strategies offer promising results, further research should be implemented to assess their appropriateness across sociocultural contexts and their long-term effectiveness in clinical practice.
Patient-reported outcome (PRO) measures must provide evidence that their development followed a rigorous process for ensuring their content validity. To this end, the collection of data is performed through qualitative interviews that allow for the elicitation of in-depth spontaneous reports of the patients’ experiences with their condition and/or its treatment. This paper provides a review of qualitative research applied to PRO measure development. A clear definition of what is a qualitative research interview is given as well as information about the form and content of qualitative interviews required for developing PRO measures. Particular attention is paid to the description of interviewing approaches (e.g., semi-structured and in-depth interviews, individual vs. focus group interviews). Information about how to get prepared for a qualitative interview is provided with the description of how to develop discussion guides for exploratory or cognitive interviews. Interviewing patients to obtain knowledge regarding their illness experience requires interpersonal and communication skills to facilitate patients’ expression. Those skills are described in details, as well as the skills needed to facilitate focus groups and to interview children, adolescents and the elderly. Special attention is also given to quality assurance and interview training. The paper ends on ethical considerations since interviewing for the development of PROs is performed in a context of illness and vulnerability. Therefore, it is all the more important that, in addition to soliciting informed consent, respectful interactions be ensured throughout the interview process.
This study assessed whether breast cancer (BC) patients express similar levels of needs for equivalent severity of symptoms, functioning difficulties, or degrees of satisfaction with care aspects. BC patients who did (or not) report needs in spite of similar difficulties were identified among their sociodemographic or clinical characteristics. Three hundred and eighty-four (73% response rate) BC patients recruited in ambulatory or surgery hospital services completed the European Organisation for Research and Treatment of Cancer Quality of Life questionnaire (EORTC QLQ)-C30 quality of life [health-related quality of life (HRQOL)], the EORTC IN-PATSAT32 (in-patient) or OUT-PATSAT35 (out-patient) satisfaction with care, and the supportive care needs survey short form 34-item (SCNS-SF34) measures. HRQOL or satisfaction with care scale scores explained 41%, 45%, 40% and 22% of variance in, respectively, psychological, physical/daily living needs, information/health system, and care/support needs (P < 0.001). BC patients' education level, having children, hospital service attendance, and anxiety/depression levels significantly predicted differences in psychological needs relative to corresponding difficulties (adjusted R2 = 0.11). Medical history and anxiety/depression levels significantly predicted differences in information/health system needs relative to degrees of satisfaction with doctors, nurses, or radiotherapy technicians and general satisfaction (adjusted R2 = 0.12). Unmet needs were most prevalent in the psychological domains across hospital services. Assessment of needs, HRQOL, and satisfaction with care highlights the subgroups of BC patients requiring better supportive care targeting.