The quality of radiation care: The results of focus group interviews and concept mapping to explore the patient’s perspective

doi:10.1016/j.radonc.2011.08.005

Radiotherapy and Oncology

Volume 102, Issue 1, January 2012, Pages 154-160

https://doi.org/10.1016/j.radonc.2011.08.005 Get rights and content

Abstract

Background and purpose

In this study, we explore the quality aspects of radiation care from the patient’s perspective in order to develop a draft Consumer Quality Index (CQI) Radiation Care instrument.

Materials and methods

Four focus group discussions with (former) cancer patients were held to explore the aspects determining the quality of radiation care. The list of aspects generated was categorised based on similarity and importance in a concept mapping procedure.

Results

Four focus group discussions revealed seven main themes related to the quality of radiation care: information provision, a patient-centred approach, professional competence, planning and waiting times, accessibility, cooperation and communication, and follow-up care. Results of concept mapping procedures revealed which items the patients considered to be most important. A radiation oncologist who is up to date about the patient’s file is of paramount importance for cancer patients receiving radiotherapy.

Conclusions

The quality aspects found through focus group discussions provided useful insight into how patients experience radiation care. Furthermore, concept mapping made these results more solid. To evaluate the quality of radiation care from the patient’s perspective, these quality aspects will be guiding in the development of a CQI Radiation Care.

Section snippets

Focus group interviews

Four focus group interviews were organised with (former) cancer patients who had recently received radiotherapy. Three radiotherapy centres agreed to participate in the study; one hospital specialising in cancer located in the capital city Amsterdam (region A), and two located in the more Eastern area (region B) of which one is an independent radiotherapy centre and one a radiotherapy department of an academic hospital. A letter of invitation signed by a radiation oncologist was sent to

Respondents

A total of 35 patients were willing to participate in the four focus group discussions (response 12.5%) resulting in 3–14 participants per group. A total of 28 patients (response 14.5%) took part in the concept mapping meetings; 17 in region A and 11 in region B.

The patient demographics are displayed in Table 1. Most participants were male, between 70 and 79 years, and had received higher education. Furthermore, most men received radiotherapy treatment for prostate cancer, whereas most of the

Results from the focus group interviews

Differences in experiences of the radiation care received led to four interactive focus group discussions. After the fourth focus group, we believed we had reached data saturation, as hardly any new quality of radiation care aspects was introduced. During the discussions, participants had difficulty keeping focused on radiotherapy treatment instead of discussing their overall treatment. However, sharing experiences with peers and learning from each other was considered as helpful in coping.

The

Results from the concept mapping procedure

The results of the first rating assignment of the concept mapping are presented as the top 10 mean importance scores (Table 2). Quality aspects that were highly valued refer to the professional competence of healthcare providers, information services, a patient-centred approach and good cooperation between healthcare professionals and (hospital) departments.An overview of all the quality aspects and their mean importance scores as included in the concept mapping procedure is presented in

Concept map

Data from the concept mapping assignments yielded a graphical presentation of all the quality aspects and their interrelationships. A nine-cluster solution was chosen as this resulted in the best interpretation of clusters (Fig. 1). The distance between the aspects, which are represented as dots with numbers, illustrates the degree of similarity between quality aspects. Clusters indicated by squares represent groups of mean statements based on similarity. The nine clusters are more or less the

Discussion

In this study, we explored patients’ experiences with radiation care and how important these aspects are in determining the quality of radiation care from the patients’ perspective. As a result, we gained more insight into the variety and especially the importance of quality of aspects. These can be arranged in seven themes: information provision, a patient-centred approach, professional competence, planning and waiting times, accessibility, cooperation and communication, and follow-up care.

Conflict of interest statement

The author(s) declare that they have no competing interests.

Role of the funding source

This work supported by the NVRO (Dutch Society of Radiation Oncologists).

Acknowledgements

We are grateful to all the patients who participated in this study and would like to thank them for sharing their experiences with us. We would also like to thank the staff of the Netherlands Cancer Institute Amsterdam, Arnhem Radiotherapy Institute, and the Department of Radiotherapy Radboud University Nijmegen Medical Centre for recruiting patients. Appreciation is also expressed to all stakeholders participating in the project meetings and Tessera Translations BV for linguistic advice.

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