Vol 25, No 2 (2022)
Letter to the Editor
Published online: 2022-06-27

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A 4.000 € way to improve perceived quality and meet expectations of thyroid cancer patients receiving therapeutic dose of Iodine-131

Evanthia Giannoula1, Christos Melidis23, Nikitas Papadopoulos4, Panagiotis Bamidis5, Vasilios Raftopoulos6, Vasiliki Chatzipavlidou7, Ioannis Iakovou1
Pubmed: 36047293
Nucl. Med. Rev 2022;25(2):138-140.

Abstract

Background: Thyroid cancer is the most common malignant disease of the endocrine system and radioiodine therapy (RAIT) is still very often used, resulting in patients staying hospitalized for a few days alone and without visitors, augmenting their stress and discomfort. Our objective was to find simple ways of improving RAIT patients’ feelings and perceived quality of the nuclear medicine (NM) department services. Material and methods: We designed a two-year study in order to enhance RAIT patients’ perceived quality of the nuclear medicine (NM) department services and expectations’ fulfillment. A questionnaire was used in order to capture patients’ perceived quality and expectations from their RAIT. Results: 549 replies were collected. Many intrinsic and extrinsic determinants were found to be positively or negatively related to the perceived quality and fulfillment of patients’ expectations of receiving RAIT. A 1% increase could be achieved by spending 110 € per RAIT room. Conclusions: In this article, we present some easily implemented changes in both personnel behavior and room amenities that could, at least in theory and based on our results, offer a 37.9% improvement in RAIT patients’ perceived quality and expectations’ fulfillment at a cost of 4169 €.

Letter to Editor

Nuclear Medicine Review 2022, 25, 2: 138–140

DOI: 10.5603/NMR.a2022.0031

Copyright © 2022 Via Medica

ISSN 1506–9680, e-ISSN 1644–4345

A 4.000 € way to improve perceived quality and meet expectations of thyroid cancer patients receiving therapeutic dose of Iodine-131

Evanthia Giannoula1Christos Melidis23Nikitas Papadopoulos4Panagiotis Bamidis5Vasilios Raftopoulos6Vasiliki Chatzipavlidou7Ioannis Iakovou1
1Nuclear Medicine Department, Academic General Hospital “AHEPA”, School of Medicine, Aristotle University of Thessaloniki, Greece
2CAP Sante, Radiation Therapy Department, Bastia, France
3milliVolt — Radiation Physics, Bastia, France
4General Hospital of Thessaloniki “Georgios Gennimatas”, Thessaloniki, Greece
5Medical Physics Laboratory, School of Medicine, Aristotle University of Thessaloniki, Greece
6Division of HIV/AIDS Epidemiological Surveillance, National Public Health Organization (EODY), Athens, Greece
7Nuclear Medicine Department, Cancer Hospital of Thessaloniki “Theagenio”, Thessaloniki, Greece

[Received 13 XII 2021; Accepted 26 V 2022]

Correspondence to: Christos Melidis, CAP Santé, Radiation Therapy Department, 13 Rue Marcel Paul, 20200 Bastia, France and milliVolt.eu, Rue Jean-Mathieu Pekle, 20200 Bastia, France, phone: 0033 661 54 63 54 and 0032 483 430 260, e-mail: melichristos@hotmail.com and cmelidis@millivolt.eu

This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.

Background: Thyroid cancer is the most common malignant disease of the endocrine system and radioiodine therapy (RAIT) is still very often used, resulting in patients staying hospitalized for a few days alone and without visitors, augmenting their stress and discomfort. Our objective was to find simple ways of improving RAIT patients’ feelings and perceived quality of the nuclear medicine (NM) department services.
Material and methods: We designed a two-year study in order to enhance RAIT patients’ perceived quality of the nuclear medicine (NM) department services and expectations’ fulfillment. A questionnaire was used in order to capture patients’ perceived quality and expectations from their RAIT.
Results: 549 replies were collected. Many intrinsic and extrinsic determinants were found to be positively or negatively related to the perceived quality and fulfillment of patients’ expectations of receiving RAIT. A 1% increase could be achieved by spending 110 per RAIT room.
Conclusions: In this article, we present some easily implemented changes in both personnel behavior and room amenities that could, at least in theory and based on our results, offer a 37.9% improvement in RAIT patients’ perceived quality and expectations’ fulfillment at a cost of 4169 .
KEY words: RAIT; perceived quality; thyroid cancer
Nucl Med Rev 2022; 25, 2: 138–140

Introduction

Thyroid cancer is the most common malignant disease of the endocrine system and one of the few cancers with a rising incidence [1]. Even if treatment protocols evolve, Radioiodine therapy (RAIT) is still used in many cases [2], resulting in patients staying hospitalized for a few days [3] alone and without visitors, due to them being radioactive, augmenting their stress and discomfort [4]. The aim of our study is to capture patients’ feelings, perceived quality, and expectations from their RAIT at the Nuclear Medicine (NM) departments and find easy ways to improve them.

Material and methods

A cross-sectional survey, based on a customized, pre-weighted, and validated questionnaire, as proposed for this type of study [5], has been created and was used on 549 patients over a period of two years at both NM departments offering RAIT of Northern Greece. Patients’ demographics and cancer (TNM) characteristics were also recorded.

Local Health authorities have given their ethical approval and patients were informed of the survey and its goals and their written approved consent were achieved before filling it in.

Statistical analysis involved the Kolmogorov-Smirnov test, Student’s test, χ2, one-way ANOVA, and Mann-Whitney-Wilcoxon test. IBM SPSS version 26 (IBM Inc., Armonk, NY) was used, and statistical significance was defined at the 95% confidence interval.

Results

Patients’ demographics and cancer (TNM) characteristics were found to be in line with data from previous studies on such cohorts [6]. Intrinsic determinants found to be positively related to perceived quality and fulfillment of patients’ expectations receiving RAIT are:

being married or in a relationship versus being divorced (p = 0.009),
being more than 50 years old (p = 0.017),
being of male sex (p = 0.015),
having lower than college/university education (p = 0.012),
being a farmer versus blue-collar (p = 0.035) or white-collar (p = 0.013),
having an aggravated TNM stage (p = 0.043),
living in a non-urban environment (p = 0.041).

Extrinsic parameters positively determining patients’ perceived quality and expectations’ fulfillment are:

being well-informed beforehand about the procedures that will be followed,
feeling that they are respected,
being reassured in detail that irradiation is not something to be afraid of and
feeling that health professionals have a genuine interest in them.

Additionally, patients mentioned that their hospitalization would be much more enjoyable if room service, decoration, facilities, and amenities would be improved. Actually, as can be seen in Table 1, more than a third of the patients would have had a better experience during RAI, if all the above would be true.

Table 1. Extrinsic parameters affecting patients’ perceived quality and expectations’ fulfillment

Personnel related

Provided in depth information

33.3%

Respect shown

25.1%

Shown interest in me

17.9%

Psychological support

17.2%

Kindness

15.1%

Human Contact

14.3%

Amenities

Room comforts (internet connection, modern furniture, decoration, etc.)

21.6%

Quality of food provided

27.1%

All the above

37.9%

Discussion

Intrinsic parameters, given that health should be a commodity accessible to all, are not supposed to be able to be altered, for example by choosing one’s patients by age, gender, marital status, etc. However, extrinsic parameters can and should be improved for both personnel and amenities via the:

Organization of in-house behavior-towards-patients seminars on a periodic basis. These seminars are best to be presented by both health professionals and patient organizations’ representatives, since this way patients’ needs are not muted, but rather put in conjunction with professionals’ experience [7, 8]. These seminars do not need to have an impact on the hospital budget, besides maybe the refreshments offered to participants and the possible traveling expenses of the presenters. If two such seminars are to be organized per year with one presenter flying in and staying one night at a hotel (the most costly scenario), the yearly cost is estimated at 820 €.
In-depth renovation of facilities. Even in countries where hourly working rates are high, such as the US or UK, a common 9.5 square-meter RAIT room renovation should not cost more than 3.310 € [9], including wall painting, floor and ceiling restoration, simple furniture and decoration emplacement, and internet connection.

Implementing the above improvements in both personnel behavior and room amenities results, at least in theory and based on our results, in a cost of around 110 € per increased percentage of improved perceived quality and expectations’ fulfillment. This results in a total cost of 4.169 € for an increase of 37,9%.

Conclusions

To our knowledge, this is the first quantitative proposal on small and inexpensive changes in NM Departments in order to augment positive impressions and feelings of hospitalized thyroid cancer patients undergoing RAIT.

Conflict of interest

The authors have no conflicts of interest to declare.

References

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  9. DH Gateway Reviews Estates and Facilities Division. https://www.gov.uk/government/publications/guidance-to-carry-out-cost-estimates-of-healthcare-buildings [Online] (13.12.2021).