Beyond satisfaction scores: exploring emotionally adverse patient experiences

Area of Science:

• Oncology
• Patient Experience Research
• Qualitative Health Research

Background:

• Improving average patient experience is a focus in patient-centered cancer care.
• Extreme negative patient experiences may offer more significant insights for quality improvement than average experiences.
• Little is known about deeply dissatisfying experiences that lead to disengagement and negatively impact patient outcomes.

Purpose of the Study:

• To establish a framework for classifying emotionally adverse patient experiences.
• To identify the range of common causes contributing to these negative experiences.

Main Methods:

• Qualitative study utilizing in-depth interviews and free-text survey comments.
• Thematic analysis of 20 open-ended patient interviews and 2389 free-text survey comments from cancer clinics.
• Identification of adverse experiences through explicit negative emotion statements, language, syntax, and tone.

Main Results:

• Emotionally adverse experiences were rarely reported in surveys (4.0%) but more common in interviews.
• Identified 3 high-level domains (system issues, technical processes, interpersonal processes) and 10 themes triggering negative emotions.
• Perception of negative experiences was influenced by a complex interplay of patient expectations and preconditions.

Conclusions:

• A taxonomy for classifying emotionally adverse patient experiences in free-text format was developed.
• Further research is recommended to correlate perceived adverse experiences with patient satisfaction ratings and healthcare utilization.