Qualitative Patient Experiences with a Person-Centered vs. Standard Model of Care for Breast Radiation Therapy (PERSON Study).

A prospective clinical trial (PERSON study) was conducted to compare anxiety and satisfaction between standard care and a 'person-centered' model of care to meet the informational and supportive needs of patients with breast cancer receiving radiation therapy. The aim of this research was to qualitatively evaluate patients' experiences from optional interviews, acquired as a secondary trial outcome, to gain further insights on the person-centered aspects of their care. Patients receiving locoregional breast radiation therapy, in free-breathing or with an active breath-hold device, were randomized 1:1 to the intervention (person-centered model) or standard care. The intervention included a 45 minute face-to-face pre-CT education with a Radiation Therapist (RTT) and the same RTT performed CT-sim, planning and treatment delivery to maintain continuity of care. Standard care had no dedicated education session led by an RTT, and typically different RTTs were involved across procedures. Patients were offered the option to participate in a semi-structured interview within 2 weeks of completing treatment. These were conducted by a single facilitator and focused on their lived radiation therapy experiences and how it could be improved. Interviews were transcribed verbatim and coded using NVivo v.12 by a single observer, with coding reviewed by a second observer. Thematic analysis was conducted separately for each arm to identify themes. A total of 41 (21 intervention, 20 standard care) completed the optional interviews until data saturation was reached. The first theme that emerged focused on the importance of consistent RTTs. Patients in both arms reported a sense of belonging, familiarity and increase in confidence during their radiation therapy experience when cared for by a consistent RTT. Some patients noted that a small, consistent team of RTTs may also provide similar feelings of comfort. Participants in the intervention arm indicated particular value in having this consistency across specific transitions (e.g. between CT-sim and beginning of treatment) to provide a sense of continuity. The second theme identified by patients in both arms was uncertainty in the radiation therapy process as a source of nervousness, particularly for those requiring use of the active breath-hold device. The third theme emphasized by patients in the intervention arm was the importance of a RTT-led education session and its impact on feelings of preparedness. The session provided opportunity for treatment specific questions and allowed for visualization of the process. The insights gained from patients' qualitative experiences with breast radiation therapy supports the role of RTTs in person-centered care. Patients specifically reported on both study arms needing to be well prepared for treatment procedures and familiar with their care team, two aspects of care that are more proactively addressed in the person-centered (intervention) model of care. [ABSTRACT FROM AUTHOR]

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