Details:

Alternative Title:
Oncol Nurs Forum
Personal Author:
Dulko, Dorothy ; Pace, Claire M. ; Dittus, Kim L. ; Sprague, Brian L. ; Pollack, Lori A. ; ... More +
Dulko, Dorothy ; Pace, Claire M. ; Dittus, Kim L. ; Sprague, Brian L. ; Pollack, Lori A. ; Hawkins, Nikki A. ; Geller, Berta M. Less -
Description:
Purpose/Objectives

To evaluate the process of survivorship care plan (SCP) completion and to survey oncology staff and primary care physicians (PCPs) regarding challenges of implementing SCPs.

Design

Descriptive pilot study.

Setting

Two facilities in Vermont, an urban academic medical center and a rural community academic cancer center.

Sample

17 oncology clinical staff created SCPs, 39 PCPs completed surveys, and 58 patients (breast or colorectal cancer) participated in a telephone survey.

Methods

Using Journey Forward tools, SCPs were created and presented to patients. PCPs received the SCP with a survey assessing its usefulness and barriers to delivery. Oncology staff were interviewed to assess perceived challenges and benefits of SCPs. Qualitative and quantitative data were used to identify challenges to the development and implementation process as well as patient perceptions of the SCP visit.

Main Research Variables

SCP, healthcare provider perception of barriers to completion and implementation, and patient perception of SCP visit.

Findings

Oncology staff cited the time required to obtain information for SCPs as a challenge. Completing SCPs 3–6 months after treatment ended was optimal. All participants felt advanced practice professionals should complete and review SCPs with patients. The most common challenge for PCPs to implement SCP recommendations was insufficient knowledge of cancer survivor issues. Most patients found the care plan visit very useful, particularly within six months of diagnosis.

Conclusions

Creation time may be a barrier to widespread SCP implementation. Cancer survivors find SCPs useful, but PCPs feel insufficient knowledge of cancer survivor issues is a barrier to providing best follow-up care. Incorporating SCPs in electronic medical records may facilitate patient identification, appropriate staff scheduling, and timely SCP creation.

Implications for Nursing

Oncology nurse practitioners are well positioned to create and deliver SCPs, transitioning patients from oncology care to a PCP in a shared-care model of optimal wellness. Institution support for the time needed for SCP creation and review is imperative for sustaining this initiative.

Knowledge Translation

Accessing complete medical records is an obstacle for completing SCPs. A 3–6 month window to develop and deliver SCPs may be ideal. PCPs perceive insufficient knowledge of cancer survivor issues as a barrier to providing appropriate follow-up care.


Subject:
[+]
Academic Medical Centers
Adult
Aftercare
Aged
Article
Breast Neoplasms
Colorectal Neoplasms
Communication Barriers
Continuity Of Patient Care
Female
Health Services Accessibility
Hospital Administrators
Humans
Insurance, Health, Reimbursement
Interviews As Topic
Male
Medical Oncology
Middle Aged
Patient Care Planning
Patient Education As Topic
Personnel, Hospital
Pilot Projects
Primary Health Care
Rural Population
Survivors
Urban Population

Source:
Oncol Nurs Forum. 40(6):575-580.
Pubmed ID:
24161636
Pubmed Central ID:
PMC4501016
Document Type:
Journal Article
Funding:
5U48DP001935-02/DP/NCCDPHP CDC HHS/United States ; CYT4/Intramural CDC HHS/United States
5U48DP001935-02/DP/NCCDPHP CDC HHS/United States ; CYT4/Intramural CDC HHS/United States Less -
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:ba52de7b7c13bc7f743d3e793dc52054146e4c3815fb004f3d9ed0bcac31f9dc
File Type:

Supporting Files

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