Assessing suitability for long-term colorectal cancer shared care: a scenario-based qualitative study
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RESEARCH ARTICLE
Open Access
Assessing suitability for long-term colorectal cancer shared care: a scenariobased qualitative study Kylie Vuong1* , Kerry Uebel1, Maria Agaliotis2, Stella Jun3, Jane Taggart1,4, Sue Suchy3, Winston Liauw5, Melvin Chin6, Kate Webber7,8 and Mark Harris1,4
Abstract Background: Shared care is the preferred model for long-term survivorship care by cancer survivors, general practitioners and specialists. However, survivorship care remains specialist-led. A risk-stratified approach has been proposed to select suitable patients for long-term shared care after survivors have completed adjuvant cancer treatment. This study aims to use patient scenarios to explore views on patient suitability for long-term colorectal cancer shared care across the risk spectrum from survivors, general practitioners and specialists. Methods: Participants completed a brief questionnaire assessing demographics and clinical issues before a semistructured in-depth interview. The interviews focused on the participant’s view on suitability for long term cancer shared care, challenges and facilitators in delivering it and resources that would be helpful. We conducted thematic analysis using an inductive approach to discover new concepts and themes. Results: Interviews were conducted with 10 cancer survivors, 6 general practitioners and 9 cancer specialists. The main themes that emerged were patient-centredness, team resilience underlined by mutual trust and stronger system supports by way of cancer-specific training, survivorship care protocols, shared information systems, care coordination and navigational supports. Conclusions: Decisions on the appropriateness of this model for patients need to be made collaboratively with cancer survivors, considering their trust and relationship with their general practitioners and the support they need. Further research on improving mutual trust and operationalising support systems would assist in the integration of shared survivorship care. Keywords: Capacity building, Colorectal neoplasms, Health communication, Health services, Primary health care, Survivorship
Background Cancer survivors, people who have experienced cancer, are a growing proportion of the population, representing 4.6% of the Australian population in 2014 and this is expected to continue to rise [1–3]. Cancer survivorship * Correspondence: [email protected] 1 School of Population Health, University of New South Wales, Sydney, Australia Full list of author information is available at the end of the article
care includes the monitoring of cancer recurrence, as well as preventive care, management of comorbidities, and psychosocial support. In Australia and internationally, the conventional model of cancer survivorship care is mainly specialist-led, with cancer survivors continuing to attend their cancer specialists long-term and relatively smaller contributions from primary care [4]. Primary care focuses on whole person care, continuity of care and comprehensiveness [5]. These core features
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