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Discordance in perceived needs between patients and physicians in oncology practice: a nationwide survey in Korea.

Authors
 Dong Wook Shin  ;  So Young Kim  ;  Juhee Cho  ;  Robert W. Sanson-Fisher  ;  Eliseo Guallar  ;  Gyu Young Chai  ;  Hak-Soon Kim  ;  Bo Ram Park  ;  Eun-Cheol Park  ;  Jong-Hyock Park 
Citation
 JOURNAL OF CLINICAL ONCOLOGY, Vol.29(33) : 4424-4429, 2011 
Journal Title
JOURNAL OF CLINICAL ONCOLOGY
ISSN
 0732-183X 
Issue Date
2011
MeSH
Adult ; Aged ; Cross-Sectional Studies ; Data Collection ; Female ; Humans ; Korea ; Logistic Models ; Male ; Middle Aged ; Needs Assessment* ; Neoplasms/therapy* ; Patient Satisfaction ; Perception ; Physician-Patient Relations*
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.
Full Text
http://jco.ascopubs.org/content/29/33/4424.long
DOI
10.1200/JCO.2011.35.9281
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
Yonsei Authors
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/95274
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