A multidimensional cancer rehabilitation program for cancer survivors: effectiveness on health-related quality of life.

OBJECTIVE: A multidimensional rehabilitation program for cancer survivors was developed to overcome cancer-related problems and to improve quality of life. The two purposes of the study were to describe the effectiveness of the program and to obtain information about patient preferences for multi or mono dimensional rehabilitation programs. SUBJECTS: cancer survivors with different diagnoses, and cancer-related physical and psychosocial problems. INTERVENTION: a 15-week rehabilitation program including individual exercise, sports, psycho-education, and information. Group-wise randomization was implemented by assigning one half of the patients to the complete program while the other half were allowed to choose which program components they considered relevant. MEASURES: Health-Related Quality of Life [RAND-36 and Rotterdam Symptom Check List (RSCL)], exercise capacity (symptom limited bicycle ergometry), muscle force (hand-held dynamometry), and patient preferences. Measurements were performed before (T0) and after the rehabilitation program (T1), and at a 3-month follow-up (T2). RESULTS: After the rehabilitation program, cancer survivors (n=63) displayed statistically significant improvements on health-related quality of life with effect sizes (ES) varying from 0.38 to 0.99 (RAND-36) and from -0.34 to -0.57 (RSCL), most persistent at 3-month follow-up. Furthermore, statistically significant improvements in exercise capacity and muscle force of upper and lower extremities were displayed after rehabilitation. If offered a choice, 80% of the patients prior to start and 58% of the patients after completion of the program indicated that they preferred the entire multidimensional program. CONCLUSION: A multidimensional rehabilitation program has statistically and clinically relevant beneficial effects on health-related quality of life, exercise capacity, and muscle force in cancer patients with different diagnoses. Furthermore, if offered the choice, the majority of cancer survivors seem to prefer multidimensional programs to programs with only one component.

Structure and reliability of Ware's Patient Satisfaction Questionnaire III: patients' satisfaction with oncological care in the Netherlands.

BACKGROUND: The present study examined the structure and reliability of the Dutch version of the Patient Satisfaction Questionnaire III (PSQ III). The PSQ III was designed to measure technical competence, interpersonal manner, communication, time spent with doctor, financial aspects, and access to care. In the Dutch version, the financial items were left aside because these are not appropriate for the Dutch socialized system. OBJECTIVES: The main objectives were to assess response bias, the number of dimensions needed to describe the PSQ III items, and the reliability of the scales. In addition, distribution characteristics were examined and norm scores to interpret satisfaction scores in an oncological setting were presented. RESEARCH DESIGN: A cross-sectional survey study.SUBJECTS The study was comprised of 1594 cancer patients from eight hospitals. MEASURES: The Dutch version of the PSQ III. RESULTS: Approximately 14% of the respondents were found to demonstrate considerable response bias. Confirmative factor analyses were performed to test three theoretical models with a varying number of dimensions among those participants who did not demonstrate response bias. The original structure did not fit the data well, but support was found for a three-factor model (with interpersonal manner, communication, and time spent with doctor loading on one factor instead of separate factors) and a one-dimensional model. CONCLUSIONS: The PSQ III seems to be an appropriate measure of cancer patients' satisfaction, with the note that the number of dimensions may vary for different patient groups and/or care settings and that it is important to be aware of response bias.

Social comparison and patient information: what do cancer patients want?

The present study focuses on social comparison processes among cancer patients. The sample consisted of 60 (ex-) cancer patients who participated in a course "coping with cancer". This study examined several aspects of social comparison: the need for comparison, the preferred direction of comparison and the influence of mode (information or contact seeking) and dimension (illness severity or coping) of social comparison as well as indicators of low well-being. The results show that the need for comparison is particularly enhanced among those who evaluate their own health negatively. In addition, the results show that patients prefer to receive information about others who are better off, but also want contact with others who are better off. In addition, they are specifically interested in receiving information about others who are coping better. Practical implications are discussed.