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The Patient Dignity Question and Enhancing Personhood in Radiation Oncology Clinical Encounters

2018; Elsevier BV; Volume: 102; Issue: 3 Linguagem: Inglês

10.1016/j.ijrobp.2018.07.1959

1879-355X

J. Burkeen, Cindy Ayala, Mel Collins, Lori P. Montross, C.M. Yashar,

Palliative Care and End-of-Life Issues

The Patient Dignity Question (PDQ) is an innovative question that may elicit a better understanding of personhood during clinical encounters. Prior studies using the PDQ have resulted in health care providers feeling more compassion and job satisfaction and patients experiencing more responsive and empathic care during their treatment. This study implemented the PDQ for patients in the radiation oncology clinic and examined trends in PDQ responses as well as patient satisfaction scores regarding care via Press Ganey reports. All patients presenting for initial consultation were eligible at our institution. The PDQ form was filled out voluntarily (in either English or Spanish) when checking in and included the question: “To help us serve you better, what do we need to know about you as a person to give you the best care possible?” The response was presented to the physician for review, prior to meeting the patient. The PDQ responses were then analyzed using an inductive/deductive approach. Coding was completed at a general level by identifying common words or phrases seen in the patient responses to condense the data into analyzable units. All coded responses were entered into Dedoose, allowing for evaluation of both the frequency and prevalence of each thematic code. Patient satisfaction scores with their radiation oncologist using Press Ganey Outpatient Oncology Reports from March 2016 (first implementation of the PDQ form) through December 2017 were also analyzed, using statistical software and paired t-testing. One hundred forty patient PDQ responses were coded during the study period. The study population consisted of 55% male and 45% female patients, with an average age of 62. The majority of patients were White (68%), followed by Hispanic (14%) and Asian (7%) populations. Eighty three percent of patients reported the consultation as their first visit to the clinic. Sixty one percent of patients were being treated for primary disease, 29% for metastatic disease, and 10% for recurrent disease. The most common disease sites were genitourinary (28%), skin (15%), breast (12%), lung (10%), and CNS (8%). The most common coded topics among patients were (in rank order): autobiographical information, character traits, concerns, and medical knowledge. Using paired t-testing, a 10 question panel of Press Ganey patient satisfaction scores regarding care by their radiation oncologist increased by an average of 2% (p<.001) from March 2016 through December 2017. This is the first study to implement the PDQ in the radiation oncology clinic, with results highlighting the common themes expressed by patients prior to receiving treatment. These findings provided useful data for clinicians and organizational leaders, and may have led to a significant improvement in patient satisfaction scores with their treating physician. Such promising results may inform others who are considering introducing the PDQ into their clinical setting.