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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Article info
Publication history
Accepted:
December 18,
2022
Received in revised form:
August 30,
2022
Received:
May 10,
2022
Publication stage
In Press Accepted ManuscriptIdentification
Copyright
© 2023 Elsevier Ltd. All rights reserved.
