The use of patient experience in improving the care pathway for patients with head and neck cancer undergoing radio-chemotherapy.

Abstract

e18625 Background: Patient satisfaction with the care received or the judgment that patients make of the quality of their care, is now recognized as essential in assessing the quality of health care. Patients and the caregivers have additional experiential knowledge that hospitals must consider in order to improve theirs performance. Methods: The objectives of our study was to determine the key points to be improved in the complex multidisciplinary course of the patient with advanced head and neck cancer undergoing curative treatment by radio-chemotherapy at Gustave Roussy oncological centre in France. To do this, we considered that the collection of the experience of patients, who had recently finished or were still in the process, was essential to design a patient course that takes into account their legitimate expectations. We realised a qualitative research in the form of an interview survey. Seven patients who completed their treatments at different times from October 2020 to September 2021 and four patients still undergoing radio chemotherapy between October to December 2021 gave their consent and participated in the study. We conducted eight face-to-face interviews, one by telephone and two by teleconference between September 2021 and January 2022. All interviews were conducted with two interviewers. Having opted for non-directive interviews, we have limited our interventions as much as possible, depending on the rhythm and content of each patient's story. Our questions focused on points the patient had not addressed by himself. Results: Patients consider the circuits of care to be fluid and the staff to be very attentive. They feel confident, respected and receive personalized care before and during the radio-chemotherapy. Nevertheless, most of the patients mentioned the lack of coordination between the carers of different specialties (medical oncology, radiotherapy, head and neck surgery) and between the institute and the home carers with difficulties in managing toxicities, especially post-treatment. Another breaking point has been the lack of information offered by medical staff about supportive care and cancer patient associations. Conclusions: Several areas for improvement emerged with regard to the coordination of care during treatment and the monitoring of post-treatment side effects. Therapeutic education, prevention and management of toxicities by specialized nurses may respond to this problem as well as digital applications in oncology. A complementary solution can be the implementation of peer patients for this complex head and neck cancer patients course. Our work will continue with a quality research on the impact of nurse-peer patient partnership.