Evaluating patient-centered care in external beam radiotherapy : a cross-sectional study in Malta

Abstract

Purpose/Objective

Patient-centered care (PCC) is key to high-quality oncology services, emphasising care that respects patients’ needs, values, and preferences while ensuring effective communication, coordinated care, and emotional support. Radiotherapy departments provide an important setting for PCC implementation due to frequent patient– healthcare provider interactions throughout treatment. However, limited research has explored PCC from patients’ perspectives on receiving external beam radiotherapy (EBRT) in Malta. This study aimed to evaluate patients’ views on PCC from cancer diagnosis until the final week of EBRT treatment and to examine whether socio-demographic factors influenced perceived PCC.

Material/Methods

A prospective cross-sectional quantitative study was conducted at a Maltese oncology centre. Adult patients receiving EBRT were recruited during their final week of treatment using convenience sampling. Participants completed the validated Quality of Patient-Centered Cancer Care (QPCCC) questionnaire, developed and implemented in various instances by Dr Tzelepis and her colleagues. This was completed alongside a demographic survey. The QPCCC assesses ten PCC dimensions, including respectful communication, treatment delivery, treatment decision-making, emotional support, coordinated and integrated care, timely care, follow-up care, cancer information, equitable care, and patient preferences and values. Data from 42 completed questionnaires were analysed using IBM SPSS Statistics version 29. Due to nonnormal data distribution, non-parametric tests including the Friedman test, Spearman correlation, and Kruskal–Wallis test were applied.

Results

Forty-two valid responses were analysed. Participants were predominantly aged 65–74 years, with equal representation of males and females. The highest mean ratings were reported for respectful communication (M = 4.738), treatment delivery (M = 4.378), and cancer information (M = 4.125). Lower ratings were observed for patient preferences and values (M = 3.063), timely care (M = 3.161), and coordinated and integrated care (M = 3.170). Differences between PCC dimensions were statistically significant (χ²(9) = 179.657, p < 0.001). Spearman analysis identified significant positive correlations between PCC domains, while timely care showed negative correlations with most domains, though not statistically significant. Significant differences (p-value < 0.05) were observed by sex, with females reporting higher scores for treatment decision-making (p-value = 0.039), respectful communication (p-value = 0.022), and patient preferences and values (p-value = 0.048).

Conclusion

Patients receiving EBRT in Malta generally reported positive PCC experiences, particularly in communication and treatment delivery. However, improvements are needed in addressing patient preferences, values, and shared decision-making to strengthen PCC in radiotherapy care. These findings highlight opportunities to enhance patient engagement and support development of more personalised and equitable oncology services within radiotherapy practice.