Patient and caregiver satisfaction with ambulatory oncology care: Agreement and predictors.

Abstract

e16567 Background: Little is known about the level of agreement between patient and caregiver individual reports of satisfaction with healthcare, and no such study has been conducted in the advanced cancer setting. Our aims were to assess the level of agreement in satisfaction with oncology care, between patients with advanced cancer and their caregivers, and to identify factors associated with satisfaction. Methods: Patients with advanced cancer and their caregivers were recruited from ambulatory oncology clinics. Satisfaction with care was measured using FAMCARE- patient and caregiver versions. Patients completed measures of symptom severity (ESAS) and quality of life (FACT-G, FACIT-Sp). Caregivers completed a quality of life measure (CQOL-C). Agreement between patient and caregiver satisfaction scores was assessed using ICC and weighted kappa statistics; multivariable regression was used to determine individual predictors of satisfaction. Results: For the 191 patient-caregiver pairs, caregivers were less satisfied than patients (mean FAMCARE score 67.5 vs. 65.7 out of a possible 90, p=0.02). Overall agreement between patients and caregivers was moderate (ICC = 0.59). Agreement for individual items on FAMCARE was low (kappa range = 0.11-0.37). Both patients and caregivers were least satisfied with information on managing pain and information regarding prognosis. Factors associated with patient satisfaction were lower education level, better quality of life, and less symptom severity; caregiver satisfaction was associated with lower education levels, and better quality of life. Conclusions: Despite considerable discrepancy between caregiver and patient ratings, there was agreement regarding which elements of care needed most improvement. Greater attention to pain control and communication regarding prognosis would further improve patient and caregiver satisfaction with care in advanced cancer