Enhancing Patient Experience in Geriatric Oncology

Patient experience will be assessed using the Older Adult Oncology Patient Experience Scale, composed by Likert scale items. measured by Likert-scale items, assess perceived comfort, age-specific care, communication, and respect during the index oncology center visit. Each item is scored on a 5-point LIKERT SCALE ranging 1 to 5, whwrw 1 indicates the least fevorable experience and 5 indicates the most favorable experience. Higher scores indicate a better patient experience.

In the post - intervention phase, assitional items will assess use of, and perceived value atributed, the comfort card and comfort menu. These items will also be scored on the same 5-point Likert scale randging 1 to 5, with higher scores indicating greater perceived values or satisfaction

The interview will fololow the standartization of the original comfort cart validation study, using the Older Adult Oncology Patient Experience Scale, composed by Likert scale items. measured by Likert-scale items, assess perceived comfort, age-specific care, communication, and respect during the index oncology center visit. Each item is scored on a 5-point LIKERT SCALE ranging 1 to 5, whwrw 1 indicates the least fevorable experience and 5 indicates the most favorable experience. Higher scores indicate a better patient experience.

In the post - intervention phase, assitional items will assess use of, and perceived value atributed, the comfort card and comfort menu. These items will also be scored on the same 5-point Likert scale randging 1 to 5, with higher scores indicating greater perceived values or satisfaction.

Institutional satisfaction will be assessed using the Transactional Net Promoter Score, calculated from the standard 0-to-10 recommendation question. Respondents scoring 9-10 will be classified as promoters, 7-8 as passives, and 0-6 as detractors. The final Transactional Net Promoter Score ranges from -100 to +100, with higher scores indicating greater institutional satisfaction.

Ombudsman manifestations related to the intervention period will be classified as complaints, suggestions, or compliments. The outcome will be reported as the number of manifestations in each category during the 30-day assessment period.

Caregiver anxiety and depression symptoms will be assessed using the Hospital Anxiety and Depression Scale (HADS). The HADS includes two subscales: anxiety and depression. Each subscale ranges from 0 to 21, with higher scores indicating greater symptom severity and therefore a worse outcome.

Caregiver burden will be assessed using the 12-item Zarit Burden Interview Short Form (ZBI-12). Each item is scored from 0 to 4, and the total score ranges from 0 to 48, with higher scores indicating greater caregiver burden and therefore a worse outcome.

Length of stay beyond the programmed duration will be assessed during the index visit to the Infusion Oncology Center. This outcome will be calculated as the difference between the actual time spent in the Infusion Oncology Center and the programmed duration of the visit, reported in minutes.

Symptom burden will be assessed using the Edmonton Symptom Assessment System (ESAS). Each symptom is scored from 0 to 10, where 0 indicates absence of the symptom and 10 indicates the worst possible symptom severity. The total ESAS symptom burden score will be calculated as the sum of the assessed symptom items, ranging from 0 to 90, with higher scores indicating greater symptom burden and therefore a worse outcome.

Understanding of the information received will be assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire - Information 25 (EORTC QLQ-INFO25). Scores will be transformed to a scale ranging from 0 to 100, with higher scores indicating better understanding of the information received and therefore a better outcome.

Oncological treatment completion will be assessed as the proportion of patients who complete the planned oncological treatment without unplanned discontinuation during the 30-day assessment period. The outcome will be reported as the number and percentage of patients who completed treatment as planned.

Basic activities of daily living will be assessed using the Katz Index of Independence in Activities of Daily Living. The total score ranges from 0 to 6, with higher scores indicating greater functional independence and therefore a better outcome.

Basic activities of daily living will be assessed using the Barthel Index of Activities of Daily Living. The total score ranges from 0 to 100, with higher scores indicating greater functional independence and therefore a better outcome.

Instrumental activities of daily living will be assessed using the Lawton-Brody Instrumental Activities of Daily Living Scale. In the version used in this study, total scores range from 9 to 27, with higher scores indicating better functionality and less dependence, from total dependence to mild dependence.

Adressed using the 10 point cognitive screener. With a score ranging from 0 to 10, it classifies cognitive performance as normal ( > = 8) , possible cognitive impeirement (6-7), or probaple cognitive imeirement (0-5), with adjustments for education level.

Mood symptoms will be assessed using the Geriatric Depression Scale - 15-item version (GDS-15). The total score ranges from 0 to 15, with higher scores indicating more depressive symptoms and therefore a worse outcome.

Number of clinical re-evaluations and unplanned hospital admissions in the 30 days following the index visit.

number of falls at 30 days.

Mortality at 30 days.

Dose reduction due to toxicity will be assessed as the proportion of patients who require any reduction in the planned oncological treatment dose because of treatment-related toxicity during the 30-day assessment period. The outcome will be reported as the number and percentage of patients with dose reduction due to toxicity.

Treatment delay or interruption due to toxicity will be assessed as the proportion of patients who experience any delay or interruption of oncological treatment because of treatment-related toxicity during the 30-day assessment period. The outcome will be reported as the number and percentage of patients with treatment delay or interruption due to toxicity.