Survivorship Care Focus Group Discussions for Breast Cancer Survivors and Primary Care Clinicians

H. Klonoff-Cohen, M. Polavarapu
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Abstract

Purpose: This is the first pilot study to examine survivors’ experiences and primary care physicians and nurse practitioners’ knowledge and behaviour practices with respect to late effects (e.g., fatigue, chemobrain, lymphodema, cardiac problems, reproductive, infertility and sexual health issues, bone problems, and pain). Methods: Two separate focus groups consisting of 5 breast cancer survivors and 5 primary care physicians and nurse practitioners recruited from a local hospital in Central Illinois answered predetermined questions about cancer survivorship care. We intentionally limited the sample in order to conduct a detailed discussion (90 minutes) to gain every participant’s perspective. Results: Breast cancer survivors expressed a void in discussion and lack of knowledge among their primary care physicians regarding late effects as well as psychological consequences, referrals to support groups, and availability of resources (e.g., finances), thereby negatively affecting survivors’ quality of life. A primary care clinician (PCC) focus group revealed a service gap for mental health services for all patients, knowledge deficit about late effects, and lack of awareness of patient resources. Both cancer survivors and PCCs were extremely supportive about a shared care survivorship model between oncology and primary care. All focus group participants were unequivocally receptive about enhancing survivorship care throughout a cancer survivor’s lifetime. Conclusion: Complementing cancer survivorship care with primary care clinicians in the areas of late effects, in addition to psychological consequences, screening, and lifestyle habits will enhance a cancer survivor’s health-related quality of life.
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乳腺癌幸存者和初级保健临床医生的幸存者护理焦点小组讨论
目的:这是第一个试点研究,旨在检查幸存者的经历以及初级保健医生和护士从业人员在后期影响(如疲劳、化学脑、淋巴水肿、心脏问题、生殖、不孕症和性健康问题、骨骼问题和疼痛)方面的知识和行为做法。方法:从伊利诺斯州中部一家当地医院招募了5名乳腺癌幸存者和5名初级保健医生和护士,组成了两个独立的焦点小组,回答了有关癌症幸存者护理的预定问题。我们有意限制样本,以便进行详细的讨论(90分钟),以获得每个参与者的观点。结果:乳腺癌幸存者表示,他们的初级保健医生对晚期影响、心理后果、转介到支持团体和资源(如经济)的可用性缺乏讨论和知识,从而对幸存者的生活质量产生了负面影响。初级保健临床医生(PCC)焦点小组发现,所有患者的精神卫生服务存在差距,对晚期影响的知识不足,对患者资源缺乏认识。癌症幸存者和PCCs都非常支持肿瘤和初级保健之间的共享护理生存模式。所有的焦点小组参与者都明确地接受在癌症幸存者的一生中加强生存护理。结论:在后期影响、心理后果、筛查和生活习惯方面,与初级保健临床医生一起补充癌症幸存者护理,将提高癌症幸存者与健康相关的生活质量。
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