Abstract
It is well recognized that oncologists should consider patients' quality of life and functioning when planning and delivering anticancer treatment, but a comprehensive assessment of how a patient feels requires a thorough inquiry. A standardized measurement of patients' quality of life may support clinicians in identifying important problems for discussion during the limited time of the medical consultations. The aim of this study was to assess the feasibility of computer-administered individual quality of life measurements in oncology clinics with immediate feedback of results to clinicians and to examine the impact of the information on consultations. The study employed a prospective non-randomized design with pre-test post-test within subjects comparisons and involved three medical oncologists and 28 cancer patients receiving chemotherapy. The intervention consisted of completion of quality of life questionnaires before the consultations and informing clinicians of the results. The main outcome measures were patients' perceptions of the content of baseline and intervention consultations and satisfaction with communication. A qualitative analysis of clinicians' interviews was performed. When clinicians had the quality of life results they enquired more often about daily activities (Z=−2.71, P=0.007), emotional problems (Z=−2.11, P=0.035) and work related issues (Z=−1.89, P=0.058). There was an increase in the number of issues discussed during the intervention consultation (Z=−1.89, P=0.059). Patients were highly satisfied with both consultations. The computer measurement was well accepted by patients who felt that the questionnaires were a useful tool to tell the doctors about their problems. The clinicians perceived that the quality of life data broadened the range of the clinical inquiry and helped them identify issues for discussion. Having symptoms and functional problems expressed quantitatively on a scale was useful for detection of change over time.
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Acknowledgements
We are very grateful to our patients who took the time to complete the study questionnaires. We wish to thank Dr D Alison, Dr P Patel and Dr J Dent and the nursing and administrative staff in the clinics whose help and support made this study possible. We are grateful for financial support to the National Lotteries Charities Board (G Velikova), the Imperial Cancer Research Fund (G Velikova, AB Smith and PJ Selby) and NHS Research & Development (JM Brown). The automated collection of QL data was supported by a grant from the NHS National Cancer Research and Development Programme. Preliminary results of this work were presented at the 1999 6th annual conference of the International Society for Quality of Life Research in Barcelona, Spain.
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Appendix 1 - Quality of life measurement in daily oncology practice: Patients’ Attitude Questionnaire
Appendix 1 - Quality of life measurement in daily oncology practice: Patients’ Attitude Questionnaire
You may remember when we first discussed with you the quality of life study that it would be helpful to have feedback from those who participated. This information will give us clearer idea about how acceptable and useful routine collection of quality of life data is to patients.
Please answer all of the questions by ticking the appropriate box. If you have any other comments about this study please write them in the space provided and the end of the questionnaire. Thank you for your help. Figure 3
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Velikova, G., Brown, J., Smith, A. et al. Computer-based quality of life questionnaires may contribute to doctor–patient interactions in oncology. Br J Cancer 86, 51–59 (2002). https://doi.org/10.1038/sj.bjc.6600001
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DOI: https://doi.org/10.1038/sj.bjc.6600001
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