Development of a Questionnaire for Measuring the Quality of Personal Care in Patients Undergoing Radiotherapy for Prostate Cancer

Abstract

Background: Quality of patient care includes both technical and non-technical elements of care, referred to as personal care. Previous work has focused on assessing the quality of technical care in prostate cancer radiotherapy, but little work has been done to assess the quality of personal care.

Purpose: The purpose of this project was to create a self-administered questionnaire to measure the quality of personal care for patients undergoing radiotherapy for early-stage prostate cancer.

Methods: Dimensions and candidate indicators of the quality of personal care were identified through a comprehensive literature search. The indicators were assigned to dimensions and then arranged into steps in the radiotherapy care continuum. A questionnaire was constructed using the indicators to assess patients’ views about the quality of their care as well as the importance of each indicator. Cognitive interviews were conducted with four health care professionals and eight patients to determine the clarity, comprehensiveness and appropriateness of the questionnaire. The questionnaire was then pilot tested on patients undergoing radiotherapy for early-stage prostate cancer.

Results: A total of 176 indicators of the quality of personal care were initially identified representing 10 dimensions of care. Cognitive interviews identified problems with the questionnaire primarily related to the clarity and redundancy of the indicators and the appropriateness of the response categories. To reduce burden, the questionnaire was divided into three modules, corresponding to appropriate steps in the continuum of care. Each module was pilot tested on at least 10 patients with an overall response rate of 84%. Most patients responded to all indicators on the questionnaire without difficulty and without distress; however patterns of missing responses indicate a few particular indicators need revision. The results suggest that the design of the questionnaire is appropriate since patients seem to be using the range of response options that are offered.

Conclusions: The results suggest that this questionnaire is feasible to administer in a clinic setting and that it does not place a large burden on patients.