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Objectives: To validate five items (CPWQ-inf) regarding satisfaction with information provided to cancer patients from health care staff, assess the prevalence of dissatisfaction with this information, and identify factors predicting dissatisfaction., Methods: The questionnaire was validated by patient-observer agreement and cognitive interviews. The prevalence of dissatisfaction was assessed in a cross-sectional sample of all cancer patients in contact with hospitals during the past year in three Danish counties., Results: The validation showed that the CPWQ performed well. Between 3 and 23% of the 1490 participating patients were dissatisfied with each of the measured aspects of information. The highest level of dissatisfaction was reported regarding the guidance, support and help provided when the diagnosis was given. Younger patients were consistently more dissatisfied than older patients., Conclusions: The brief CPWQ performs well for survey purposes. The survey depicts the heterogeneous patient population encountered by hospital staff and showed that younger patients probably had higher expectations or a higher need for information and that those with more severe diagnoses/prognoses require extra care in providing information., Practical Implications: Four brief questions can efficiently assess information needs. With increasing demands for information, a wide range of innovative initiatives is needed., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

Purpose: If patients facing difficulties in the process of returning to work after treatment of cancer could be identified, these patients could be assisted in the transition. This might help some patients to stay in work. We therefore assessed demographic and clinical factors associated with returning to work after a cancer diagnosis., Materials and Methods: In this cross-sectional survey, 1490 cancer patients who had been in contact with a hospital department during the past 12 months in three Danish counties responded to a mailed questionnaire. Factors associated with employment and return to work (i.e., working more than 0 h in the past month) respectively, were assessed in multivariate ordinal logistic regression models., Results: Of the 598 patients below age 65 who were employed at the time of diagnosis, 75% were still employed when answering the questionnaire at a median of 2.8 years after diagnosis and 63% were working. In multivariate analyses, younger and more recently diagnosed patients were more often employed. Patients diagnosed with lung or head and neck cancer were least likely to be employed and having returned to work. Advanced cancer at diagnosis was associated with loss of employment. Advanced cancer and being in active treatment were associated with not having returned to work., Conclusion: A quarter of the patients had lost their employment probably resulting in economic consequences on the individual as well as at the societal level. The highest risk was observed for older patients and those diagnosed with lung or head and neck cancer., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Purpose: Patients' perceptions of care including the communication with health care staff is recognized as an important aspect of the quality of cancer care. Using mixed methods, we developed and validated a short instrument assessing this communication., Methods: Based on focus group interviews with 77 informants, an 8-item instrument was developed. This short instrument aimed at assessing overall aspects of the communication between cancer patients and health care staff. The items were validated first through cognitive interviews with patient-observer agreement with 52 cancer patients who completed the questions and then participated in tape-recorded open-ended interviews. Observer ratings of the interviews were compared with the patients' written responses collected before interviews and kappa values were calculated. The comprehensibility of each item was subsequently elaborated in traditional cognitive interviews with 17 cancer patients. Finally, psychometric analyses took place with data from 1490 cancer patients., Results: The weighted kappas concerning patient-observer agreement ranged 0.31-0.88. Disagreements mainly consisted of the observer choosing the response category indicating the highest level of satisfaction whereas the patients had chosen the second highest level. Cognitive interviews showed that the questions were generally interpreted as intended. One item was excluded due to low validity. A sum scale of the remaining seven items had high reliability (Cronbach's alpha 0.89)., Conclusions: Seven items performed well. They proved to be valid measures of satisfaction with communication with the health care staff and constitute a sum scale with high reliability. The cognitive interviews provided valuable insight into the patients' perception of communication., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Context: To improve palliative care, it is important that questionnaires accurately assess the needs of the patients. No questionnaire existed that combined three different and important approaches to needs assessment. We developed such a questionnaire, called the Three-Levels-of-Needs Questionnaire (3LNQ), based on literature searches. The 3LNQ measures 12 important needs with three different approaches when used as a supplement to the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30): problem intensity, problem burden, and felt need., Objectives: To investigate the initial validity of the 3LNQ., Methods: We used a relatively new method that investigates whether the questionnaire has the same meaning for the patients as for the researchers. To do this, 74 patients with advanced cancer filled out the questionnaire and participated in an open-ended interview. The patients' responses to the questionnaire before the interview were compared against the researchers' responses based on the interviews. Items showing substantial agreement were accepted as valid without further analysis. For the remaining items, reasons for disagreements were analyzed qualitatively., Results: All items on problem intensity, eight of 12 items on problem burden, and three of 12 items on felt need were accepted as valid because of high agreement. Analysis of the qualitative data concerning the remaining items showed that most disagreements did not indicate problems with the patients' self-assessment. Instead, different causes for disagreements were elucidated, but these did not interfere with validity., Conclusion: The 3LNQ appears to measure palliative needs comprehensively, and this initial validation showed satisfactory results. The analysis gave important insights into the patients' perceptions of their own situations, into their expectations of the health care system, and into the complexity of needs assessment., (Copyright © 2011 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.)