QUOTEchemo: A patient-centred instrument to measure quality of communication preceding chemotherapy treatment through the patient’s eyes
Received 11 March 2009; received in revised form 30 May 2009; accepted 9 June 2009. published online 17 July 2009.
Abstract
Background
Knowing patients’ needs is a prerequisite to ensure high quality cancer care. This study describes the development and psychometric properties of a patient-centred instrument to measure needs and actual experiences with communication preceding chemotherapy treatment: QUOTEchemo. QUOTE-questionnaires (Quality Of care Through the patients’ Eyes) are widely used to gain insight into unmet needs, but no validated, standardised questionnaire combining patients’ needs and experiences surrounding chemotherapy treatment is available yet.
Methods
To evaluate the psychometric properties of the QUOTEchemo, content validity, internal structure and convergent validity were investigated amongst 345 cancer patients, new to chemotherapy, from 10 different hospitals.
Results
Literature study, focus group discussions and a categorisation procedure of 67 relevant topics revealed seven main themes: Treatment-related information, Prognosis information, Rehabilitation information, Coping information, Interpersonal communication, Tailored communication and Affective communication. Confirmatory factor analysis using structural equation modelling indicated that the measurement model provided good fit to the data with factor loadings ranging from .43 to .77. The seven QUOTEchemo dimensions captured relevant issues of concern with good internal consistency (α .72–.92), satisfactory item-total correlations (.35–.79) and satisfactory convergent validity. Affective communication, Treatment-related information and Rehabilitation information were perceived most important by patients. The instrument also appeared to be able to determine which aspects need improvement to ensure high quality care. The highest need for improvement was found for communicating Prognosis information and Rehabilitation information and for Interpersonal communication.
Conclusions
These findings provide preliminary evidence of the reliability and validity of the QUOTEchemo for use in cancer care surrounding chemotherapy treatment. Researchers and health care providers can use the instrument to measure patients’ needs and experiences with communication to identify aspects that need improvement.
aAmsterdam School of Communications Research (ASCoR), University of Amsterdam, Kloveniersburgwal 48, 1012 CX Amsterdam, The Netherlands
bNetherlands Institute for Health Services Research (NIVEL), P.O. Box 1568, 3500 BN Utrecht, The Netherlands
cSchool of Public Health, Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), University of Sydney, Edward Ford Building (A27), NSW 2006, Australia
dDepartment of Health Psychology, Utrecht University, The Netherlands
ABSTRACT