Development and implementation barriers of a new patient-reported measure: The Radiation therapy-related Inconvenience Questionnaire (RIQ)

Chindhu Shunmugasundaram; Puma Sundaresan; Kate White; Madeleine T King; Chris Milross; Lucinda Rodd; Matthew Fuller; Claudia Rutherford

doi:10.1111/1754-9485.13586

Development and implementation barriers of a new patient-reported measure: The Radiation therapy-related Inconvenience Questionnaire (RIQ)

J Med Imaging Radiat Oncol. 2023 Oct;67(7):777-788. doi: 10.1111/1754-9485.13586. Epub 2023 Sep 24.

Authors

Chindhu Shunmugasundaram^{1

2}, Puma Sundaresan^{3

4}, Kate White⁵, Madeleine T King², Chris Milross^{4

6}, Lucinda Rodd⁷, Matthew Fuller⁷, Claudia Rutherford^{2

5}

Affiliations

¹ Faculty of Science, School of Psychology, Centre for Medical Psychology and Evidence-based Decision-making, The University of Sydney, New South Wales, Sydney, Australia.
² Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Sydney Quality of Life Office, The University of Sydney, New South Wales, Sydney, Australia.
³ Radiation Oncology Network, Western Sydney Local Health District, New South Wales, Sydney, Australia.
⁴ Sydney Medical School, The University of Sydney, New South Wales, Sydney, Australia.
⁵ Cancer Nursing Research Unit, The University of Sydney, Susan Wakil School of Nursing and Midwifery, New South Wales, Sydney, Australia.
⁶ Radiation Oncology and Medical Services, Chris O'Brien Lifehouse, New South Wales, Sydney, Australia.
⁷ Radiation Oncology, Central West Cancer Centre, New South Wales, Orange, Australia.

PMID: 37742323
DOI: 10.1111/1754-9485.13586

Abstract

Introduction: Radiation therapy (RT) can benefit approximately 50% of cancer patients and contribute to 40% of all cancer cures, yet its utilisation in cancer is low globally. Several factors contribute to this including perceived inconvenience related to accessing and utilising RT. To quantitatively assess the latter, a new tool - the Radiation therapy-related Inconvenience Questionnaire (RIQ) - was developed. This study aimed to pre-test the RIQ and explore barriers and facilitators to implementing it in routine clinical practice and clinical trials.

Methods: Semi-structured cognitive interviews were conducted with patients undertaking RT, recruited via three hospitals to examine content validity, acceptability, and comprehensibility of the RIQ. Interviews identified inconsistencies, relevance, and clarity of items. Semi-structured interviews with healthcare professionals involved in the delivery of care to individuals undertaking RT explored barriers and facilitators to routine usage. Thematic analysis was used to identify themes.

Results: Patients (N = 15) identified problems in content, instructions, layout, length, and response options; consequently, 25 items were revised and eight removed, resulting in a final 29-item questionnaire. Clinicians identified staff- and patient-specific barriers to implementing RIQ in clinical practice. Perceived facilitators included the following: (a) workplace factors, (b) mode of administration, and (c) imparting knowledge.

Conclusion: This study demonstrated acceptability and comprehensibility of the 29-item RIQ amongst cancer patients undertaking RT and treating clinicians. The next phase will evaluate the RIQ's measurement properties in a larger clinical study. The barriers and facilitators identified can guide future implementation of RIQ in clinical practice and clinical trials.

Keywords: cognitive debriefing; implementation; inconvenience; patient-reported outcome measure; radiation therapy.

MeSH terms

Attitude of Health Personnel*
Humans
Neoplasms* / radiotherapy
Patient Reported Outcome Measures
Qualitative Research
Surveys and Questionnaires

Grants and funding

Sydney Catalyst Pilot and Seed Funding 2020