Patient-expressed perceptions of wait-time causes and wait-related satisfaction

Patient-expressed perceptions of wait-time causes and wait-related satisfaction The article review should be 2 pages. Paper format should be double-spaced, Times New Roman Font (size 12), and APA format. The paper should be in your own words. Paragraph One: Introduce the topic of the article by summarizing the issue or problem discussed in the article (in your own words) Paragraph Two – Four: Summarize the main research presented in the article Proposal/Question Data/Results Conclusion/Applications Final Paragraph Personal response to article How it applies to the course How you liked it PERCEPTIONS OF WAIT-TIME CAUSES 105 C urrent O n CO l O gy — V O lume 22, n umber 2, A pril 2015 Copyright © 2015 Multimed Inc. Following publication in Current Oncology , the full text of each article is available immediately and archived in PubMed Central (PMC). ORIGINAL ARTICLE Patient-expressed perceptions of wait-time causes and wait-related satisfaction M. Mathews p h d ,* D. Ryan ma ,* and D. Bulman p h d † underlying reasons for wait-related satisfaction or dissatisfaction. Although our findings shed light on patient experiences with the health system and identify where interventions could help to inform the expectations of patients and the public with respect to wait time, more research is needed to understand wait-related satisfaction among cancer patients. KEY WORDS Wait times, patient satisfaction, breast cancer, pros - tate cancer, colorectal cancer, lung cancer 1. BACKGROUND “Patient satisfaction” refers to personal evaluations by patients about whether their lived health care ex - periences measure up to their expectations 1 . Patient satisfaction is generally accepted as a dimension of quality of care 2 and patient-centred care 3 . A num - ber of studies have examined patient satisfaction in cancer care and have highlighted communication between the physician (and other members of the team) and the patient 3,4 . Nonetheless, wait times for care are frequently cited as a cause of patient dis - satisfaction with the health care system 5 . Studies examining wait times for cancer care and wait-related satisfaction have a number of limitations. First, some studies examine the length of time spent in a waiting room preceding a single visit; few stud - ies have looked at waits as patients progress from symptoms, to testing, and to diagnosis and treatment. Second, some researchers have described wait times for the various intervals from symptoms to treat - ment, but we found only one Canadian study that considered patient satisfaction with those waits. In a study of colorectal cancer patients in Nova Scotia, researchers found only a modest correlation between length of wait and wait-related satisfaction 6 . Does patient satisfaction vary based on the cause of the wait? Wait times along the pathway from symptoms to treatment are commonly described in ABSTRACT Background This study set out to identify patterns in the causes of waits and wait-related satisfaction. Methods We conducted qualitative interviews with urban, semi-urban, and rural patients ( n = 60) to explore their perceptions of the waits they experienced in the detection and treatment of their breast, prostate, lung, or colorectal cancer. We asked participants to de - scribe their experiences from the onset of symptoms to the start of treatment at the cancer clinic and their satisfaction with waits at various intervals. Interview transcripts were coded using a thematic approach. Results Patients identified five groups of wait-time causes: • Patient-related (beliefs, preferences, and non-cancer health issues) • Treatment-related (natural consequences of treatment) • System-related (the organization or functioning of groups, workforce, institution, or infrastructure in the health care system) • Physician-related (a single physician responsible for a specific element in the patient’s care) • Other causes (disruptions to normal operations of a city or community as a whole) With the limited exception of physician-related absences, the nature of the cause was not linked to overall satisfaction or dissatisfaction with waits. Conclusions Causes in themselves do not explain wait-related satisfaction. Further work is needed to explore the Curr Oncol , Vol. 22, pp. 105-112; doi: http://dx.doi.org/10.3747/co.22.2243 MATHEWS et al. 106 C urrent O n CO l O gy — V O lume 22, n umber 2, A pril 2015 Copyright © 2015 Multimed Inc. Following publication in Current Oncology , the full text of each article is available immediately and archived in PubMed Central (PMC). the literature as resulting from patient and provider delay. “Patient delay” refers to the interval from the onset of symptoms to the first medical consultation, usually with the patient’s regular physician 7–9 . “Pro - vider delay” refers to the period after the first visit to a health care provider (in Canada, usually the general practitioner or family physician) 6,10,11 . The terminol - ogy suggests that waits during those periods result from the provider or the patient. For example, a lengthy wait to see a physician about symptoms is attributed to the patient, and delays occurring after the initial visit are attributed to physician- or health system–related issues. Although some studies have described patient and provider delays, we were unable to find studies that examined the relationship between patient satisfaction and wait time causes. The purpose of the present study was therefore to identify patterns in causes of waits and wait-related satisfaction. Using qualitative interviews, we asked patients from Newfoundland and Labrador to describe their experiences from the onset of symptoms to the start of treatment at the cancer clinic. As in other provinces in Canada, Newfoundland and Labrador has invested resources in improving wait times for cancer care 12 . By examining the care-seeking process, we adopt a patient-centred approach and aim to better understand the patient’s experience of cancer and interactions with the health care system. The study contributes to the understanding of public perceptions of wait times and efforts to improve timely access to cancer care. 2. METHODS Memorial University’s Human Investigations Com - mittee approved the study. We conducted semis - tructured qualitative interviews with breast, lung, colorectal, and prostate cancer patients who, in an earlier survey, had expressed satisfaction or dis - satisfaction with their wait times while seeking care for their cancer. Eligible study participants were residents of New - foundland and Labrador who were 19 years of age or older and who had been diagnosed between January 2009 and August 2011. We excluded participants with previous or multiple cancer diagnoses because their wait-time experiences might differ from those of patients who are diagnosed with one type of cancer for the first time. For the initial survey, we recruited cancer patients from regional cancer clinics across the province and mailed invitations to individuals identi - fied through the provincial cancer registry. The survey gathered information about dates in the care-seeking process, satisfaction with interval-specific wait times (for example, from symptoms to first visit with a health care provider, from first visit to diagnosis, and so on), and clinical and personal characteristics. A fuller description of the survey procedures are provided elsewhere 13 . At the end of the survey, respondents were invited to take part in the qualitative interview, and willing respondents were later contacted to complete consent forms and schedule interviews. Patients were selected for an interview based on their responses to survey questions about com - munity of residence and satisfaction with various waits. From among the survey respondents, we identified urban (population =100,000), semi-urban (population 10,001–99,999), and rural (population =10,000) residents who were satisfied or dissatisfied with their overall wait time from onset of symptoms to care at the cancer clinic. Because patients were overwhelmingly satisfied with the overall wait time, we then amended our recruitment to patients who had expressed dissatisfaction with any wait interval. For each cancer type and community size, we recruited a minimum of 3 patients who were satisfied or dis - satisfied with their wait time experiences. The final number of interviews was determined when satura - tion of ideas and concepts was reached 14 . The interviews were conducted in person or by telephone and ranged in length from 8 minutes to 82 minutes. We asked participants about their wait times and causes of waits from onset of symptoms to receiving treatment for their cancer, their level of satisfaction with those wait times, any barriers to receiving care in their community, factors that might make cancer care accessible in their area, and what could have been done to improve their wait times or the quality of care that they received. Each interview was tape-recorded and later transcribed verbatim. Using a thematic approach, three members of the research team each independently read 4 transcripts to identify key themes and concepts. We then devel - oped a template to code the remaining transcripts. To ensure consistency in coding, we defined and described each code. Each transcript was then read and coded by two members of the team (one research assistant read and coded all transcripts). Throughout this process, data from previous interviews were con - tinuously compared to identify concepts, categories, clusters, and themes 14,15 . Disagreements in coding were resolved by consensus. Where disagreements arose, members of the research team re-examined the descriptions of individual themes to determine the source of disagreement. Those discussions led, as needed, to clarification of code and theme definitions, the creation of new themes, or the integration of new ideas within a theme. The NVivo 9 qualitative data analysis software (version 9, 2010: QSR International, Doncaster, Australia) was then used to re-code all transcripts using the final coding template. In the present article, we focus on the causes of disruptions in timely care. Numbers are used to identify individual participants. 3. RESULTS Of 128 invited patients, 60 (46.9%) participated in an interview. Table i shows participant characteristics