Exploratory Factor Analysis of a Patient-Centered Cancer Care Measure to Support Improved Assessment of Patients’ Experiences

• Published in: Value in health 2020-03, Vol.23 (3), p.351-361
• Main Authors: Mitchell, Kerri-Anne R., Brassil, Kelly J., Fujimoto, Kayo, Fellman, Bryan M., Shay, Laura Aubree, Springer, Andrew E.
• Format: Article
• Language: English
• Subjects: Breast; Breast cancer; cancer; Cancer therapies; Cross-Sectional Studies; Decision making; Discriminant analysis; Emotions; Exploratory factor analysis; Factor analysis; Factor Analysis, Statistical; Female; Health Communication; Health information; Health Status; Humans; instrument development; Male; Medical Oncology; Mental Health; Middle Aged; Neoplasms - diagnosis; Neoplasms - physiopathology; Neoplasms - psychology; Neoplasms - therapy; Patient Reported Outcome Measures; Patient Satisfaction; Patient-Centered Care; Patients; Prostate; Prostate cancer; Psychosocial factors; Quality of care; Quality of Life; Social interactions; Social Support; Statistical analysis; Treatment Outcome
• ISSN: 1098-3015; 1524-4733
• DOI: 10.1016/j.jval.2019.10.004

To increase the understanding of patient-centered care (PCC) and address the need for cross-cutting quality cancer care measures that are relevant to both patients and providers. An exploratory factor analysis (EFA) was performed on a short version of the Patients and the Cancer Care Experience Survey, a patient-reported measure of perceived importance of social, emotional, physical, and informational aspects of care, administered to adult patients (n = 104) at a National Cancer Institute-designated comprehensive cancer center. Relationships between PCC dimensions and patient characteristics were also assessed. Principal axis factoring was applied and bivariate analyses were performed using Wilcoxon rank-sum tests. Most of our sample was over 60 years old (63.4%), female (57.4%), and white (74.2%), with either breast (41.2%) or prostate cancer (27.5%). A 5-factor model was identified: (1) quality of life (α = .91), (2) provider social support (α = .83), (3) psychosocial needs (α = .91), (4) nonprovider social support (α = .79), and (5) health information and decision-making support (α = .88). No statistically significant associations were found between these factors and patients’ characteristics. A preliminary factor structure for a cancer PCC measure was identified. Our findings reinforce the interrelated nature of PCC dimensions. The lessons learned from this study may be used to develop a single PCC measure that identifies patient priorities across the cancer care continuum. Data collected from such a measure can be used to support patient engagement in treatment planning and decision-making. •Cross-cutting quality measures developed with strong psychometric properties and patient input are needed to assess and achieve high-quality patient-centered cancer care.•A latent factor structure for patient-centered care (PCC) among cancer patients was identified that included symptom and care experiences, representing a core set of concepts for simplified evaluation.•These findings may guide the future validation of a PCC measure that informs providers of patient concerns that influence care decision making.