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Patient perception, experience, and satisfaction has gained increasing importance in today’s cancer care. This is evident in the widespread use of patient satisfaction measures in hospitals, such as Press Ganey, and the current focus on patient-reported outcomes (PROs) in cancer research.1,2,3 However, there is a paucity in research investigating which factors are meaningful to cancer patients’ experiences surrounding their surgery. The article by Shinall et al. addresses this important aspect of cancer care.4 Through a qualitative analysis of cancer patients undergoing major abdominal surgery, Shinall et al. identified multiple factors important to patients during the operative and perioperative experience. From patient interviews, they highlight various themes, but of particular significance was the importance of timeliness of care to cancer patients.
The importance of timeliness of cancer care is not new to medical and surgical oncologists, as research has shown time and time again the importance of timely cancer care for multiple cancer types, including breast, colorectal, and lung cancer to improve oncologic outcomes.5,6,7,8 However, this paper, highlights the importance of timeliness from a patient’s perspective. Timeliness was a potential source of emotional distress, if they experienced perceived delays in care, or a source of relief, when they perceived a sense of urgency in their care. Interestingly, time to surgery was only one component of timeliness that concerned patients. Patients also reported operative time, length of hospitalization, timeliness or responsiveness to questions and requests, and time-spent during visits with the provider to also be of importance. These findings underscore the need for healthcare systems to support timely evaluation and treatment of cancer patients and for surgeons to provide adequate time with patients to present clear expectations about the preoperative, operative, and recovery period.
This research highlights the importance of qualitative and mixed-methods analyses in cancer research. Qualitative research allows for an in-depth analysis of what is meaningful to patients and of the implications of healthcare systems practices and processes. The application of qualitative methodology has been limited in health services and surgical research as it has often been criticized due to its limited ability to apply its findings to the general population.9 This critique is fair, including for the study by Shinall et al., as qualitative research often focuses on a unique subset of patients. limiting the generalizability of its findings. However, qualitative research is also able to provide an in-depth and rich understanding of the topic of interest for this subset of patients that is not possible with most quantitative methods. Qualitative research, like the study by Shinall et al., demonstrates how this methodology may be systematically applied to provide a thorough analysis and understanding of what outcomes and processes are important to cancer patients. Identifying outcomes that are meaningful to patients is imperative for cancer research to optimize these outcomes and patient care.2 But this is only the first step, as after we identify processes and outcomes meaningful to patients, it is imperative that we then evaluate the effectiveness of interventions on improving these processes and outcomes for cancer patients. This may be approached through various methods, including clinical trials.
In summary, as patient perception and experience has become a priority in cancer care, employing qualitative and mixed-methods approaches to identify outcomes and processes meaningful to patients has become increasingly important. The findings from these in-depth analyses must then be incorporated into future research with the goal of improving cancer care in outcomes that matter to patients. This may be applied to the findings reported by Shinall et al., as their findings suggest a need for future research endeavors to focus on the development and implementation of interventions that may be used by hospital systems to prevent delays in cancer care.
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Bateni, S.B. Timeliness in Cancer Care from the Patient Perspective. Ann Surg Oncol 30, 2574–2575 (2023). https://doi.org/10.1245/s10434-023-13152-9
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DOI: https://doi.org/10.1245/s10434-023-13152-9