Needs and preferences of patients with cancer

Abstract

What do patients prefer in cancer care and does gender matter? Introduction: To provide patient-centred care for cancer patients it is important to have insight into the patients' specific preferences for health care. To gain such insight we have developed a questionnaire based on cancer patients’ own input. We also used this questionnaire to address gender specific preferences in cancer care. Methods: Items for the questionnaire were generated during ten focus group interviews. The preliminary questionnaire was completed by 386 cancer patients (57% response rate) treated by medical oncologists in seven Dutch hospitals. Factor analysis resulted in a final questionnaire (123 items in 21 scales and 8 single items). Mann-Whitney tests were used to identify significant gender differences. For statistically significant differences, effect sizes (ESs) were calculated. Multivariable regression analysis was used to determine the impact of gender on preferences compared to other patient- and disease related factors. Results: Patients rated safety and the expertise, performance and attitude of physicians and nurses as the most important issues in cancer care. The scales ‘Presence of loved ones’, ‘Privacy’, ‘Patient habits’ and ‘Conveniences’ scored among the relatively less important items. There were significant gender differences concerning preferences in health care in fifteen out of 21 scales and two out of eight single items. Invariably, women valued care aspects in these scales and single items as more important than men. Effect sizes varied from 0.27 to 0.71. A moderate to large effect was found for the scales ‘Waiting periods’, ‘Nurse attitude’, ‘Support, counselling and rehabilitation’ and for the single item ‘Continuity in care’. Multivariable regression analysis showed that gender had the strongest impact on patient preferences. Discussion: The results of this study are a valid and reliable starting point in care renewal processes and may be used to guide decisions in improving care for cancer patients and to include gender specific differences as an integral part of care. Our questionnaire may be used to assess patients’ preferences and to come to a tailored approach of health care.