Discordance in perceived needs between patients and physicians in oncology practice

A nationwide survey in Korea

Dong Wook Shin, So Young Kim, Juhee Cho, Robert W. Sanson-Fisher, Eliseo Guallar, Gyu Young Chai, Hak Soon Kim, Bo Ram Park, Euncheol Park, Jong Hyock Park

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Purpose: Identification of supportive care needs in patients with cancer is essential for planning appropriate interventions. We aimed to determine patient-physician concordance in perceived supportive care needs in cancer care and to explore the predictors and potential consequences of patient-physician concordance. Patients and Methods: A national, multicenter, cross-sectional survey of patient-physician dyads was performed, and 97 oncologists (participation rate, 86.5%) and 495 patients (participation rate, 87.4%) were included. A short form of the Comprehensive Needs Assessment Tool for Cancer Patients was independently administered to patients and their oncologists. Concordance and agreement rates between physicians and patients were calculated. Mixed logistic regression was used to identify predictors of concordance and to explore the association of concordance with patient satisfaction and trust in physicians. Results: Physicians systematically underestimated patient needs and patient-physician concordance was generally poor, with weighted κ statistics ranging from 0.04 to 0.15 for individual items and Spearman's ρ coefficients ranging from 0.11 to 0.21 for questionnaire domains. Length of experience as oncologist was the only significant predictor of concordance (adjusted odds ratio for overall concordance [aOR] = 2.09; 95% CI, 1.02 to 4.31). Concordance was not significantly associated with overall patient satisfaction (aOR = 1.24; 95% CI, 0.74 to 2.07) or trust in physician (aOR = 1.17; 95% CI, 0.76 to 1.81). Conclusion: Our findings revealed significant underestimation of patient needs and poor concordance between patients and physicians in assessing perceived needs of supportive care. The clinical implications of this discordance warrant further investigation.

Original languageEnglish
Pages (from-to)4424-4429
Number of pages6
JournalJournal of Clinical Oncology
Volume29
Issue number33
DOIs
Publication statusPublished - 2011 Nov 20

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Korea
Physicians
Patient Satisfaction
Surveys and Questionnaires
Patient Participation
Neoplasms
Needs Assessment
Cross-Sectional Studies
Logistic Models
Odds Ratio

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Shin, D. W., Kim, S. Y., Cho, J., Sanson-Fisher, R. W., Guallar, E., Chai, G. Y., ... Park, J. H. (2011). Discordance in perceived needs between patients and physicians in oncology practice: A nationwide survey in Korea. Journal of Clinical Oncology, 29(33), 4424-4429. https://doi.org/10.1200/JCO.2011.35.9281
Shin, Dong Wook ; Kim, So Young ; Cho, Juhee ; Sanson-Fisher, Robert W. ; Guallar, Eliseo ; Chai, Gyu Young ; Kim, Hak Soon ; Park, Bo Ram ; Park, Euncheol ; Park, Jong Hyock. / Discordance in perceived needs between patients and physicians in oncology practice : A nationwide survey in Korea. In: Journal of Clinical Oncology. 2011 ; Vol. 29, No. 33. pp. 4424-4429.
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abstract = "Purpose: Identification of supportive care needs in patients with cancer is essential for planning appropriate interventions. We aimed to determine patient-physician concordance in perceived supportive care needs in cancer care and to explore the predictors and potential consequences of patient-physician concordance. Patients and Methods: A national, multicenter, cross-sectional survey of patient-physician dyads was performed, and 97 oncologists (participation rate, 86.5{\%}) and 495 patients (participation rate, 87.4{\%}) were included. A short form of the Comprehensive Needs Assessment Tool for Cancer Patients was independently administered to patients and their oncologists. Concordance and agreement rates between physicians and patients were calculated. Mixed logistic regression was used to identify predictors of concordance and to explore the association of concordance with patient satisfaction and trust in physicians. Results: Physicians systematically underestimated patient needs and patient-physician concordance was generally poor, with weighted κ statistics ranging from 0.04 to 0.15 for individual items and Spearman's ρ coefficients ranging from 0.11 to 0.21 for questionnaire domains. Length of experience as oncologist was the only significant predictor of concordance (adjusted odds ratio for overall concordance [aOR] = 2.09; 95{\%} CI, 1.02 to 4.31). Concordance was not significantly associated with overall patient satisfaction (aOR = 1.24; 95{\%} CI, 0.74 to 2.07) or trust in physician (aOR = 1.17; 95{\%} CI, 0.76 to 1.81). Conclusion: Our findings revealed significant underestimation of patient needs and poor concordance between patients and physicians in assessing perceived needs of supportive care. The clinical implications of this discordance warrant further investigation.",
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Shin, DW, Kim, SY, Cho, J, Sanson-Fisher, RW, Guallar, E, Chai, GY, Kim, HS, Park, BR, Park, E & Park, JH 2011, 'Discordance in perceived needs between patients and physicians in oncology practice: A nationwide survey in Korea', Journal of Clinical Oncology, vol. 29, no. 33, pp. 4424-4429. https://doi.org/10.1200/JCO.2011.35.9281

Discordance in perceived needs between patients and physicians in oncology practice : A nationwide survey in Korea. / Shin, Dong Wook; Kim, So Young; Cho, Juhee; Sanson-Fisher, Robert W.; Guallar, Eliseo; Chai, Gyu Young; Kim, Hak Soon; Park, Bo Ram; Park, Euncheol; Park, Jong Hyock.

In: Journal of Clinical Oncology, Vol. 29, No. 33, 20.11.2011, p. 4424-4429.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Discordance in perceived needs between patients and physicians in oncology practice

T2 - A nationwide survey in Korea

AU - Shin, Dong Wook

AU - Kim, So Young

AU - Cho, Juhee

AU - Sanson-Fisher, Robert W.

AU - Guallar, Eliseo

AU - Chai, Gyu Young

AU - Kim, Hak Soon

AU - Park, Bo Ram

AU - Park, Euncheol

AU - Park, Jong Hyock

PY - 2011/11/20

Y1 - 2011/11/20

N2 - Purpose: Identification of supportive care needs in patients with cancer is essential for planning appropriate interventions. We aimed to determine patient-physician concordance in perceived supportive care needs in cancer care and to explore the predictors and potential consequences of patient-physician concordance. Patients and Methods: A national, multicenter, cross-sectional survey of patient-physician dyads was performed, and 97 oncologists (participation rate, 86.5%) and 495 patients (participation rate, 87.4%) were included. A short form of the Comprehensive Needs Assessment Tool for Cancer Patients was independently administered to patients and their oncologists. Concordance and agreement rates between physicians and patients were calculated. Mixed logistic regression was used to identify predictors of concordance and to explore the association of concordance with patient satisfaction and trust in physicians. Results: Physicians systematically underestimated patient needs and patient-physician concordance was generally poor, with weighted κ statistics ranging from 0.04 to 0.15 for individual items and Spearman's ρ coefficients ranging from 0.11 to 0.21 for questionnaire domains. Length of experience as oncologist was the only significant predictor of concordance (adjusted odds ratio for overall concordance [aOR] = 2.09; 95% CI, 1.02 to 4.31). Concordance was not significantly associated with overall patient satisfaction (aOR = 1.24; 95% CI, 0.74 to 2.07) or trust in physician (aOR = 1.17; 95% CI, 0.76 to 1.81). Conclusion: Our findings revealed significant underestimation of patient needs and poor concordance between patients and physicians in assessing perceived needs of supportive care. The clinical implications of this discordance warrant further investigation.

AB - Purpose: Identification of supportive care needs in patients with cancer is essential for planning appropriate interventions. We aimed to determine patient-physician concordance in perceived supportive care needs in cancer care and to explore the predictors and potential consequences of patient-physician concordance. Patients and Methods: A national, multicenter, cross-sectional survey of patient-physician dyads was performed, and 97 oncologists (participation rate, 86.5%) and 495 patients (participation rate, 87.4%) were included. A short form of the Comprehensive Needs Assessment Tool for Cancer Patients was independently administered to patients and their oncologists. Concordance and agreement rates between physicians and patients were calculated. Mixed logistic regression was used to identify predictors of concordance and to explore the association of concordance with patient satisfaction and trust in physicians. Results: Physicians systematically underestimated patient needs and patient-physician concordance was generally poor, with weighted κ statistics ranging from 0.04 to 0.15 for individual items and Spearman's ρ coefficients ranging from 0.11 to 0.21 for questionnaire domains. Length of experience as oncologist was the only significant predictor of concordance (adjusted odds ratio for overall concordance [aOR] = 2.09; 95% CI, 1.02 to 4.31). Concordance was not significantly associated with overall patient satisfaction (aOR = 1.24; 95% CI, 0.74 to 2.07) or trust in physician (aOR = 1.17; 95% CI, 0.76 to 1.81). Conclusion: Our findings revealed significant underestimation of patient needs and poor concordance between patients and physicians in assessing perceived needs of supportive care. The clinical implications of this discordance warrant further investigation.

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