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Why We Surveyed
We engaged with patients of the Provincial Cancer Care Program to assess their overall experience of care. This was done through a standardized survey, the Ambulatory Oncology Patient Satisfaction Survey (AOPSS), which is used in jurisdictions across Canada. This allows for national comparisons and a comprehensive understanding of program strengths and areas for improvement.
Who We Surveyed
We surveyed patients aged 18 years or older who received active cancer care treatment in an ambulatory (outpatient) setting during April 2024-January 2025. A package was mailed to participants, containing information about the survey and instructions for completion. Participants were able to complete the survey virtually or on paper.
The survey received a total of 1580 responses, resulting in a 42% response rate. Of survey respondents, 49% identified as men and 51% as women. Of those who responded, 4% were age 44 or younger, 29% were between age 45 and 64, 63% were between age 65 and 84, and 4% were age 85 or older. This was the first cancer diagnosis for 71% of respondents and a repeat diagnosis for 29% of respondents. Of respondents, 57% were engaged in treatment to cure their cancer, while 40% had a goal of controlling their symptoms. Those who responded to the survey were representative of the overall cancer care population by gender, age, and some cancer types (colorectal, lung, and lymphoma). However, survey respondents over-represented patients with breast cancer, prostate cancer, and those who had been diagnosed with cancer multiple times.
What We Heard
What We're Doing Well
The areas patients rated most positively are highlighted below, along with examples that supported this area of strength.
Patients were satisfied with their overall care
- 98% rated their overall care as good, very good, or excellent
- 91% would completely recommend health care providers to friends and family
- 98% of those who had a virtual care appointment rated their virtual care as good, very good, or excellent
The top strengths of virtual care were:
- Provider listened to what the patient had to say
- Patients knew who to contact if they had problems
- Patients were able to discuss physical symptoms
Patients felt trust in - and relationship with - care providers
- 96% were treated with respect and dignity
- 94% trusted providers with confidential information
- 93% believed their care providers did everything they could to treat their cancer
Patients were satisfied with communication on key treatment elements
- 94% were given clear and understandable instructions on how to take their oral medication;
- 85% felt they received enough information to manage their care at home; and
- 85% reported that their care provider completely explained why they needed tests in a way they could understand.
Where We Can Improve
Although the survey findings were generally positive, there were areas for improvement. The areas patients rated most poorly are outlined below, along with examples that supported this area of need.
Holistic Care and Patient Wellness
- 41% were not referred to a care provider to help with anxieties and fears
- 35% reported not receiving enough help coping with sexual health issues
- 32% reported not receiving enough help coping with spiritual issues
Empowering Patients in Decision Making About Their Care
- 35% were asked by a healthcare provider about “what treatments I would want or not want if I developed a life-threatening illness”
- 32% were asked by a healthcare provider about “what is important to me (values, spiritual beliefs, or other practices) as I make decisions about my health care”
- 28% were asked by a healthcare provider about Advance Care Planning, or "if I have written documents that support my medical decisions, if I cannot speak for myself”
Dimensions of Patient-Centred Care
The AOPSS survey tool includes questions to measure seven predefined dimensions of patient-centred care, with each dimension consisting of a set of related questions that contribute to an overall score. This score is calculated by taking the percentage of respondents who answered favourably (e.g., "Always") to specific questions. The overall scores were:
- Overall Satisfaction: 98%
- Respect for Patient Preference: 85%
- Physical comfort: 81%
- Coordination of Care: 76%
- Access to Care: 71%
- Information, Education, and Communication: 69%
- Emotional Support: 53%
Survey analysis identified key drivers of patients’ overall care experience. We learned that patients have a better overall experience of care when they:
- have enough information about changes in sexual activity
- receive sufficient support in coping with sexual health issues
- receive enough support coping with spiritual issues
- are asked about Advance Care Planning
Next Steps
The results will be used by the Provincial Cancer Care Program to guide program planning and develop an action plan for quality improvement.
Learn More
For further information on this project or the outcomes, contact MyVoiceNL@nlhealthservices.ca.
The Office of People-Centred Measurement, NL Health Services, prepared this report.