Patient perceptions of a community-based intervention designed to provide support post administration of anti-cancer systemic treatments: A qualitative evaluation

Heather McKenzie; Lillian Hayes; Louise Acret; Chantale Boustany; Bora Kim; Judith Fethney; Judy M Simpson; Jodi McLeod; Simon Willcock; Natalie Cook; Kate White

doi:10.1016/j.ejon.2022.102148

Patient perceptions of a community-based intervention designed to provide support post administration of anti-cancer systemic treatments: A qualitative evaluation

Eur J Oncol Nurs. 2022 Jun:58:102148. doi: 10.1016/j.ejon.2022.102148. Epub 2022 May 16.

Authors

Heather McKenzie¹, Lillian Hayes², Louise Acret³, Chantale Boustany⁴, Bora Kim⁵, Judith Fethney², Judy M Simpson⁶, Jodi McLeod⁷, Simon Willcock⁸, Natalie Cook⁹, Kate White⁴

Affiliations

¹ Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Australia. Electronic address: h.mckenzie@sydney.edu.au.
² Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Australia.
³ Cancer Care Research Unit, Faculty of Medicine and Health, The University of Sydney, Australia; The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Australia.
⁴ Cancer Care Research Unit, Faculty of Medicine and Health, The University of Sydney, Australia; The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Australia; Sydney Local Health District, Australia.
⁵ Cancer Care Research Unit, Faculty of Medicine and Health, The University of Sydney, Australia; Nursing & Midwifery and Health Sciences, Faculty of Medicine, Notre Dame University, USA.
⁶ Sydney School of Public Health, University of Sydney, Australia.
⁷ Sydney District Nursing, Sydney Local Health District, Australia.
⁸ MQ Health, Macquarie University Hospital, Primary Care, Australia.
⁹ Faculty of Medicine and Health, University of NSW, Australia.

PMID: 35661898
DOI: 10.1016/j.ejon.2022.102148

Abstract

Purpose: This paper reports on patient participant experiences of a larger randomised controlled trial evaluating a shared-care pathway intervention designed to support outpatients at home during their first three cycles of systemic anti-cancer therapies delivered in two large tertiary hospitals in Sydney, Australia. This qualitative study explores the perspectives of patient participants who received the intervention, which involved targeted home visits by community nurses post treatment administration.

Methods: A qualitative inductive thematic analysis was used to examine data from semi-structured interviews with patients who received the intervention.

Results: Twenty-five patient participants were interviewed. We identified four themes: Stepping into the unknown; Impact of availability of health and social care support; Building confidence to manage self-care; Uncertainty, frailty and co-morbidities. Targeted support at home is seen to be effective and welcomed by patients as early stages of each treatment cycle can be extremely challenging, particularly for those who are elderly, frail or with co-morbidities, and for those with limited health and social support.

Conclusion: Regular contact with community nursing services can, at least for some patients, support the development of patient self-efficacy in managing aspects of their own care. Some patients are sufficiently confident to self-manage some treatment side effects by treatment cycle four.

Keywords: Cancer; Chemotherapy; Co-morbidities; Community nursing; Qualitative research; Self-management; Systemic anti-cancer therapies.

Publication types

Randomized Controlled Trial

MeSH terms

Aged
Australia
Humans
Qualitative Research
Self Care*
Social Support*