Satisfaction with Nurse-led Follow-up in Prostate Cancer Patients-A Nationwide Population-based Study

Abstract

Background: Satisfaction with nurse-led follow-up among men with prostate cancer is high. However, it is unclear whether all men are satisfied or whether there are men who would benefit from being followed by a urologist or a nurse.

Objective: To investigate the follow-up distribution between urologists and nurses, and whether the high self-reported satisfaction with nurse-led follow-up is independent of other factors such as age or comorbidity.Design, setting, and participants:All Swedish men, ≤70 yr of age, with a low-risk prostate cancer diagnosis in 2008, answered a questionnaire 7 yr after diagnosis. The extensive questionnaire included a question on satisfaction with care, answered on a seven-point scale. Participants were divided based on whether they were followed up by a nurse, a urologist, or both.Outcome measurements and statistical analysis:Factors that could influence the level of satisfaction were identified as age, education, comorbidity, treatment, disease progression, urinary bother, level of information, and participation in treatment decision. Likelihood ratio tests from ordinal regression were used to test the null hypothesis of similar satisfaction between groups.

Results and limitations: Out of 1288 men, 1137 (88%) answered both the question on who performed the follow-up and the question regarding satisfaction. In all, 350 men reported that they were followed up by nurses (31%), 598 (52%) by urologists, and 189 (17%) by both. No differences in satisfaction where seen between the groups. Approximately 50% were satisfied completely, regardless of who performed the follow-up. Results were not affected by age, educational level, comorbidity, treatment, disease progression, urinary bother, information, or participation in treatment decision. Limitations include the nonrandomized, retrospective design and a potential recall bias.

Conclusions: Satisfaction with nurse-led follow-up is high, regardless of factors such as age, level of education, comorbidity, and treatment.

Patient summary: Men with prostate cancer can be offered nurse-led follow-up on a regular basis and still maintain their satisfaction with health care.

Keywords: Active surveillance; Low-risk prostate cancer; Nurse-led follow-up; Population based; Satisfaction; Self-reported.

Fig. 1

Self-rated satisfaction in the whole cohort without any subgroups and compared between follow-ups conducted by nurse, urologist, or the combination of both (n = 948).

Fig. 2

Self-rated satisfaction compared between follow-ups conducted by nurse, urologist, or the combination of both (n = 948). The patients are divided into subgroups based on (A) age, (B) level of education, (C) comorbidity, and (D) treatment. AS = active surveillance; CCI = Charlson comorbidity index; RP = radical prostatectomy; RT = radiotherapy.

Fig. 3

Self-rated satisfaction compared between follow-ups conducted by nurse, urologist, or the combination of both (n = 948). The patients are divided into subgroups based on (A) information about the illness and its course, and (B) participation in treatment decision.