Variations in patient satisfaction with care for breast, lung, head and neck and prostate cancers in different cancer care settings Andreas Charalambous * Research Centre for Oncology and Palliative Care, Nursing Department, School of Health Sciences, Cyprus University of Technology,15th Vragadinou Streer, 3041 Limassol, Cyprus Keywords: Patient satisfaction Cancer care Survey Nursing care Oncology settings abstract Purpose of the research: To assess cancer patients’ satisfaction and the extent to which it varies between cancer care centres. Methods and sample: This is a multi-site descriptive study reporting on the satisfaction of patients with breast, prostate, head and neck and lung cancers in Cyprus. The sample consisted of 272 patients ran- domly selected. Data were retrieved with the Patient satisfaction Scale additionally to 7 single questions reflecting 7-care dimensions namely “access to care”, “explanation at first visit”, “understanding of diagnosis and treatment”, “first treatment: respect communication and involvement”, “first treatment: pain and discomfort”, “first treatment: hospital management” and “discharged co-ordination”. Results: Participants were overall satisfied by the nursing care (mean 3.5) however, dissatisfaction was expressed in relation to the 7-care dimensions (p < 0.001). Variations in satisfaction were found across the oncology settings as well as across cancer types. The variables gender, age, marital status, level of education, length of stay in the department, previous hospitalization, tumour type and treatment type had an influence on patients’ perceived satisfaction (p < 0.001). Conclusions: Seemingly identical nursing care can be measurably different between cancer care centres. Based on the findings the satisfaction variations can be attributed to factors personally experienced by the patients as well as to systemic hospital-level factors. The notion of patient satisfaction is important to clinical practice as a tool to assess and plan the nursing care and managers should bear in mind that patient satisfaction is sensitive to person specific variables as well as to many extraneous variables. Ó 2013 Elsevier Ltd. All rights reserved. Introduction Since the first use of the term “satisfaction” by Thorndike (1911) to reference a unique state of existence for a living organism, the term has received numerous conceptualizations as well as appli- cations in health care. Patient satisfaction with nursing care has been defined as the patient’s opinion on the received care from the nurses (Wagner and Bear, 2009) and often the patient’s expecta- tions form the structure against which satisfaction is evaluated (Kane et al., 1997; Risser, 1975). In recent years, the assessment of patient satisfaction has somewhat become an important means for evaluating the quality of nursing care because it gives information on the provider’s success at meeting those values and expectations which are matters on which the patient is the ultimate authority. Drawing on the principles of the Donabedian theory of quality (Donabedian, 1980) patient satisfaction can be classified as an outcome quality indicator (Johansson et al., 2002) whilst others view it as a separate dimension (Kane et al., 1997). The proposed structure, process and outcome quality indicators by Donabedian (1966) has generated an international debate of which indicators are better in the assessment of quality of health care, and argu- ments have been proposed in favour of one or another quality in- dicator (Gross, 2012). Donabedian (1966) himself triggered this debate by stating that “Outcomes remain the ultimate validators of the effectiveness and quality of medical care” and at the same time acknowledging that process criteria “may, however, be more rele- vant to the question at hand: whether medicine is properly prac- ticed” (p168). Mant (2001) asserts that it is simplistic to view process and outcome measures as being in competition with each other, however at the same time he acknowledged that there are circumstances when one type of measure is more useful than the other (p475). There are no “magic portions” answers to this debate and as Gross (2012) asserts this debate is likely to continue whilst the solution lays perhaps in the consideration of aspects such as the type of the disease, the information being requested, the effective implementation of the measurement effort, and the evidence base * Tel.: þ357 25002011; fax: þ357 25002822. E-mail address: andreas.charalambous@cut.ac.cy. Contents lists available at SciVerse ScienceDirect European Journal of Oncology Nursing journal homepage: www.elsevier.com/locate/ejon 1462-3889/$ e see front matter Ó 2013 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.ejon.2013.01.006 European Journal of Oncology Nursing 17 (2013) 588e595