Healthcare experiences of people with advanced colorectal cancer: A qualitative study. (April 2023)

• Record Type: Journal Article
• Authors: Lim, Chloe Yi Shing; Laidsaar-Powell, Rebekah C.; Young, Jane M.; Steffens, Daniel; Ansari, Nabila; Joshy, Grace; Butow, Phyllis; Lim, Chloe Yi Shing; Laidsaar-Powell, Rebekah C.; Young, Jane M.; Solomon, Michael; Steffens, Daniel; Koh, Cherry; Ansari, Nabila; Yeo, David; Blinman, Prunella; Beale, Philip; Koczwara, Bogda; Joshy, Gracy; Butow, Phyllis
• Is Part Of: European journal of oncology nursing. Volume 63(2023)
• Publication Date: 2023-04
• Subjects: Advanced cancer -- Bowel cancer -- Healthcare system -- Psychosocial services -- Quality of life -- Supportive care; Cancer -- Nursing -- Periodicals; Cancer -- Research -- Periodicals; Oncology -- Periodicals; Oncology Nursing -- Periodicals; Neoplasms -- nursing -- Periodicals; Cancer -- Soins infirmiers -- Périodiques; Cancer -- Recherche -- Périodiques; Cancérologie -- Périodiques; Verpleegkunde; Kanker; Cancer -- Nursing; Cancer -- Research; Oncology; Electronic journals; Periodicals; Electronic journals; 616.9940231
• DOI: 10.1016/j.ejon.2022.102265
• Languages: English
• ISSNs: 1462-3889

Abstract

Abstract: Purpose: Qualitative research examining healthcare experiences and needs of people with advanced (metastatic or recurrent) colorectal cancer CRC-A is limited. This study aimed to fill this gap in CRC-A survivors treated with surgical or palliative chemotherapy, through a qualitative study. Method: Australian adults treated for CRC-A were recruited 0.5–2 years post-surgery or post-diagnosis of CRC-A (for palliative chemotherapy groups). Semi-structured telephone interviews, analysed via framework analysis, explored healthcare experiences. Demographic, clinical, and quality of life data characterised the sample and informed framework analyses. Data was compared against the Institute of Medicine's framework for quality healthcare. Results: Interviews from 38 participants (22 female) of median age 59 years (range 27–84) revealed six overarching themes relating to the safety, effectiveness, timeliness, patient-centredness, efficiency, and equity of CRC-A care: 1) Early experiences influence later perceptions ; 2) Trusting the system, trusting the professionals ; 3) The benefits of multidisciplinary care co-ordination; 4) Feeling lost in follow-up ; 5) Whose role is it anyway? Gaps in responsibility for survivorship care ; and 6) Useful or useless? Perceptions of psychosocial support. Conclusions: Healthcare systems for CRC-A can be improved through delivery of repeated information, upskilling general practitioners and/or implementing written survivorship care plans or survivorship clinics, to ensure quality healthcare. Highlights: Advanced colorectal cancer survivors may feel lost in follow-up. There is confusion about which doctor is responsible for survivorship challenges. Repeated information delivery may help survivors to feel supported and informed. Multidisciplinary care can be beneficial, yet burdensome for survivors. GPs can provide quality care co-ordination following upskilling and training.