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Healthcare experiences of people with advanced colorectal cancer: A qualitative study

Published:January 02, 2023DOI:https://doi.org/10.1016/j.ejon.2022.102265

      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.

      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 (IOM's) framework for quality healthcare.

      Results

      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.

      Keywords

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