cultural and organizational adaptation of the quote breast cancer questionnaire for italian breast units

Background: quality of care in breast cancer is a widely researched topic, with many objectively measurable indicators of quality in healthcare. however, while there is a large consensus on the importance of patient’s perspective in breast cancer care process, there are only a few tools to measure such subjective indicators, and none of them has been validated for its use in italy yet. objectives: the aim of this methodological study was to validate a cultural and organizational adaptation of the quality of care through the patient’s eyes breast cancer (quote-bc) questionnaire for its use in italian breast units. methods: the quote-bc questionnaire was translated, adapted for the italian context and pre-tested on a small sample of breast cancer patients during their hospital stay. the questionnaire was then administered to a large sample of patients from december 2016 to may 2017 in order to further validate it. a visual analogue scale (vas) was also handed out to assess patients' level of satisfaction. results: a total of 212 patients filled the questionnaire. confirmatory factor analysis corroborated the five-factor structure of the original questionnaire explaining 80.2% of the total variance. the cronbach alpha ranged from 0.69 to 0.84 showed a good level of internal consistency. the vas difference between the groups of patients giving positive and negative answers showed that, in almost all the items, there was a statistically significant difference in patients’ level of satisfaction between the two groups. conclusions: in this study, we validated the first italian adaptation of the quote-bc (it-quote-bc) questionnaire, which represents a valuable tool for supporting clinical and organizational decisions in italian breast units. moreover, the routine use of the it-quote-bc questionnaire in the same breast unit is a tool to verify the improvement in organizational quality change as perceived by the patients.