Nadia Rajaram1, Zhi Ying Lim1, Chin Vern Song1, Ranjit Kaur2, Nur Aishah Mohd Taib3, Mazanah Muhamad4,5, Wee Loon Ong6, Maartje Schouwenburg7,8, Mee Hoong See3, Soo-Hwang Teo1,3, Christobel Saunders9, Cheng Har Yip10. 1. Breast Cancer Research Group, Cancer Research Malaysia, Subang Jaya, Malaysia. 2. Breast Cancer Welfare Association, Petaling Jaya, Malaysia. 3. Department of Surgery, University Malaya Cancer Research Institute, Kuala Lumpur, Malaysia. 4. KanWork Cancer Society, Seri Kembangan, Malaysia. 5. Faculty of Education, Universiti Putra Malaysia, Seri Kembangan, Malaysia. 6. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia. 7. Breast Cancer Working Group, International Consortium for Health Outcomes Measurement, Cambridge, Massachusetts, USA. 8. Dutch Institute for Clinical Auditing, Amsterdam, The Netherlands. 9. School of Surgery, University of Western Australia, Subiaco, Australia. 10. Department of Surgery, Subang Jaya Medical Centre, Subang Jaya, Malaysia.
Abstract
OBJECTIVES: Patient-reported outcomes (PROs) in high-income countries (HICs) suggest that physical, emotional, and psychological needs are important in cancer care. To date, there have been few inconsistent descriptions of PROs in low-income and middle-income Asian countries. Using a standard questionnaire developed by the International Consortium for Health Outcomes Measurement (ICHOM), we compared the perceived importance of PROs between patients in Malaysia and those in HICs and between clusters of Malaysian women. METHODS: Breast cancer patients were recruited from three Malaysian hospitals between June and November 2017. We compared the proportion of patients who rated PROs as very important (scored 7-9 on a 9-point Likert scale) between Malaysian patients and data collected from patients in HICs via the ICHOM questionnaire development process, using logistic regression. A two-step cluster analysis explored differences in PROs among Malaysian patients. RESULTS: The most important PROs for both cohorts were survival, overall well-being, and physical functioning. Compared with HIC patients (n = 1177), Malaysian patients (n = 969) were less likely to rate emotional (78% vs 90%), cognitive (76% vs 84%), social (72% vs 81%), and sexual (30% vs 56%) functioning as very important outcomes (P < 0.001). Cluster analysis suggests that older, parous, Malaysian women, who were less likely to have received breast reconstructive surgery, were more likely to rate body image and satisfaction with the breast as very important outcomes. CONCLUSION: Taking into account the differences in PROs by cultural and socioeconomic settings could improve patient expectation of services and refine the assessment of cancer care outcomes.
OBJECTIVES:Patient-reported outcomes (PROs) in high-income countries (HICs) suggest that physical, emotional, and psychological needs are important in cancer care. To date, there have been few inconsistent descriptions of PROs in low-income and middle-income Asian countries. Using a standard questionnaire developed by the International Consortium for Health Outcomes Measurement (ICHOM), we compared the perceived importance of PROs between patients in Malaysia and those in HICs and between clusters of Malaysian women. METHODS:Breast cancerpatients were recruited from three Malaysian hospitals between June and November 2017. We compared the proportion of patients who rated PROs as very important (scored 7-9 on a 9-point Likert scale) between Malaysian patients and data collected from patients in HICs via the ICHOM questionnaire development process, using logistic regression. A two-step cluster analysis explored differences in PROs among Malaysian patients. RESULTS: The most important PROs for both cohorts were survival, overall well-being, and physical functioning. Compared with HIC patients (n = 1177), Malaysian patients (n = 969) were less likely to rate emotional (78% vs 90%), cognitive (76% vs 84%), social (72% vs 81%), and sexual (30% vs 56%) functioning as very important outcomes (P < 0.001). Cluster analysis suggests that older, parous, Malaysian women, who were less likely to have received breast reconstructive surgery, were more likely to rate body image and satisfaction with the breast as very important outcomes. CONCLUSION: Taking into account the differences in PROs by cultural and socioeconomic settings could improve patient expectation of services and refine the assessment of cancer care outcomes.
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