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Table 3 Comparisons and contributions of thematic classes to patient-centered care dimensions

From: Computer-assisted textual analysis of free-text comments in the Swiss Cancer Patient Experiences (SCAPE) survey

Thematic classes of free-text comments

Patient-centered care dimensions of closed-ended questions

Exemples of questions

Contributions of thematic analysis of free-text comments to closed-ended questions

Cancer care pathways and breast cancer care pathways

Clinical information

What is your principal cancer diagnosis?

How long has it been since you were first treated for this cancer?

What type(s) of treatment have you received?

Thematic analysis added details on the temporal course of cancer diagnosis, care and clinical pathways.

Note: the questions related to clinical information were not part of the patient-centered care dimensions assessed by the closed-ended questions.

Medical care

Coordination and integration of care

Did the different people treating and caring for you work well together to give you the best possible care?

In your opinion, were there enough nurses on duty to care for you in hospital?

Thematic analysis added details on specific issues related to coordination between different healthcare professionals and integration of services: e.g. negative comments on individual physicians and specific episodes, comments on aspects such as ‘staff changes’ or ‘doctor looking tired or overwhelmed’ not evaluated by closed-ended questions.

Gratitude and praise

Emotional support

Did you trust the doctors/nurses treating you?

During your hospital visit, did you find someone on the hospital staff to talk to about your worries and fears?

Thematic analysis added detailed descriptions of and reasons for the positive aspects of care and relationships with a wide variety of actors (e.g. doctor, nurse, therapist, social worker, receptionist, cleaning personnel): specific thanks, gratitude, and qualities (e.g. kind, caring, competent, empathic, attentive, available, extraordinary, dedicated, excellent).

Cancer and me:

initial shock

Respect for patients’ preferences

How do you feel about the way you were told you had cancer? [done sensitively?]

Information and education

Did you understand the explanations about what was wrong with you?

Thematic analysis added description of the impact of learning they had cancer (e.g. shock), which was not assessed in closed-ended questions.

Patients’ needs and suggestions to improve the delivery of the diagnosis and other important medical information were also a valuable contribution obtained from thematic analysis.

Cancer and me:

loneliness

Emotional support

During your hospital visit/while you were being treated as an outpatient, did you find someone on the hospital staff to talk to about your worries and fears?

Continuity and transition

Did hospital staff give you information about support or self-help groups for people with cancer?

During/after your cancer treatment, did you receive enough care and support from health/social services?

Thematic analysis added description of the impact of poor experiences of care regarding emotional support and continuity of care. This included: patients’ feelings of loneliness during and after treatment (e.g. while managing side effects, accessing complementary medicine, or resuming a professional activity after treatments); and patient’s needs and suggestions on how to alleviate loneliness (e.g. help & support with administration & finances).

Cancer and me: understanding and acceptance

Information and education

Did you understand the explanations about what was wrong with you?

Were the results of the diagnostic test explained in a comprehensible manner?

Involvement of family and friends

When you were first told that you had cancer, had you been told you could bring a family member or friend with you?

Thematic analysis added information on support (or lack thereof) from families, friends or support groups in accepting the disease, and on the negative impact of lack of understanding from medical staff, employers, and insurance companies.

Cancer and me:

cancer repercussions

Health-related quality of life

I have a lack of energy; I am able to enjoy life; I worry that condition will get worse; I have nausea; I am content with the quality of life right now; I am sleeping well; I have pain [‘not at all’ to ‘very much’]

Continuity and transition

Did hospital staff discuss with you or give you information about the impact cancer could have on your day to day activities?

Did hospital staff give you information about how to get financial help or any benefits you might be entitled to?

Physical comfort

Do you think the hospital did everything they could to help control you pain?

Thematic analysis added detailed descriptions of how cancer affected patients’ (and their families’) quality of life, including physical and emotional health, family, social and professional life, financial impact, and fears, as well as reports on how difficult it is to have a “normal life” after cancer treatment.

Note: the seven questions on health-related quality of life were not part of the patient-centered care dimensions assessed by the closed-ended questions; they were from the rapid version of the functional assessment of cancer therapy-general (FACT-G7) instrument.

Cancer and me:

information and communication

Information and education

Were the possible side effects of treatment(s) explained in a comprehensible manner?

Continuity and transition

Were you offered practical advice and support in dealing with the side effects of your treatment(s)?

Coordination and integration of care

Did the different people treating and caring for you work well together to give you the best possible care?

Complementary medicine

Have you used any complementary medicine?

Thematic analysis added information on patients’ needs and suggestions for: better access to and explanation regarding medical information (including side-effects); better communication between healthcare professionals; and better recognition and integration of complementary medicine by doctors