Initial breast cancer consult: Improving satisfaction and impact on distress.

Abstract

e18284 Background: Goals of this performance improvement project were to: (1) determine the impact of initial breast cancer consultation on distress and number of reported problems as measured by the NCCN Distress Thermometer and Problem List (DT and PL) questionnaire and to: (2) explore the relationship between pre-consult DT and PL scores and patients’ satisfaction with information received during the consult as measured by the EORTC QLQ-INFO25. Methods: (1) Immediately prior to, and after, initial consult with the breast cancer surgeon, 59 convenience-sampled women completed NCCN DT and PL questionnaires. (2) They then completed an EORTC QLQ-INFO25 questionnaire designed to measure information satisfaction. Participants were placed in quartile groups based on DT score and, likewise, grouped based on number of reported problems on the PL. Quartile groups were then analyzed to determine scale satisfaction with the information provided. Results: (1) Both DT and PL pre-post changes were significantly positive (DT: M = 5.4, SD = 3.0 versus M = 3.6, SD = 2.8; t-test p< .000); (PL: M = 5.3, SD = 4.4 versus M = 3.7, SD = 4.3; t-test p< .000). Except for the INFO25 RECLESS scale (less information desired), lower scores are better. (2a.) Generally, high distress and problems reported (i.e., scores increase), guarantees lower information satisfaction. (2b.) With one exception, the quartile range for each scale was consistently small. (2c.) Score trajectories for both DT and PL quartiles over the scales were similar. Conclusions: Although data suggests current consultation processes are significantly effective, there is room for satisfaction improvement. (2a.) Providers who continue to give the DT and PL prior to a consult, must ensure information satisfaction to pre-consult DT and PL high scorers. (2b.) Similar quartile scores for each scale suggests that individually tailoring the consultation based on pre-consult DT or PL scores alone (without satisfaction improvement efforts) may have minimal benefits. (2c.) Consult satisfaction improvement efforts should focus on the following scales: INFOCD (information on CD/tape/video); RECMORE (more information wanted); INFOTHSE (other services); INFOHELP (things you can do to help yourself get well); INFODIFP (different places of care); INFOTREAT (treatments), and; INFODIS (the disease).