Keywords

Cancer survivor, Care plan, Implementation, Neoplasms, Posttreatment, Survivors

 

Authors

  1. Nolte, Linda BHSc (Nutrition Dietetics), GradDipHlthServMgt
  2. Kinnane, Nicole RN, OncCert, GradDipPsych-Onc
  3. Lai-Kwon, Julia BMedSci/MBBS (Hon)
  4. Gates, Priscilla BN, RN, GradDipCanNursing, MPhil
  5. Shilkin, Pauline BSW, GradDipAdEd
  6. Jefford, Michael PhD, MBBS, MPH, MHlthSerMt, GAICD, FRACP

Abstract

Background: In 2005, the Institute of Medicine recommended that all cancer patients receive a survivorship care plan (SCP). Despite widespread support, few centers have routinely implemented them. Understanding of their impact is limited.

 

Objectives: The aims of this study were to examine the impact of SCP delivery on patients and healthcare professionals at an Australian comprehensive cancer center and determine enablers and barriers to implementation.

 

Methods: Six groups were surveyed: (1) patients who had received SCPs; (2) nurse coordinators using SCPs, (3) general practitioners (primary care, GPs) of patients who had received SCPs, (4) clinical service chairs, (5) heads of allied health, and (6) nurse coordinators not using SCPs (nonengaged nurse coordinators). Groups 1 to 3 completed written questionnaires. Groups 4 to 6 participated in semistructured interviews.

 

Results: Fifty patients, 7 nurse coordinators, 18 GPs, 7 clinical service chairs, 4 heads of allied health, and 8 nonengaged nurse coordinators participated. Eighty-seven percent of patients considered the SCP to be very or somewhat useful; 50% felt it helped them understand their cancer experience. All engaged nurse coordinators reported SCPs to be very or somewhat useful, and 86% believed SCPs improved communication with GPs. General practitioners felt SCPs were very or somewhat useful (67%) and wished to receive SCPs for future patients (83%). Organizational and clinical leadership, multidisciplinary engagement, resourcing, and timing of SCP delivery were considered critical enablers.

 

Conclusion: Patients and healthcare professionals support the use of SCPs; however, they are resource intensive and require significant organizational support.

 

Implications for Practice: Nurses are instrumental to SCP implementation. Attention to enablers and barriers is important for successful implementation.