School of Population Health, The University of Queensland, Cancer Prevention Research Centre, Herston, Queensland 4006, Australia.
Support Care Cancer. 2011 Dec;19(12):1975-82. doi: 10.1007/s00520-010-1041-4. Epub 2010 Nov 16.
This study aims to explore and examine experiences and perceptions of follow-up care (medical and psychosocial) after active treatment for breast cancer among women living outside major Australian cities.
Twenty-five semi-structured telephone interviews were conducted. Participants also completed a brief questionnaire to collect demographic, diagnosis, and treatment information. Interviews were audio-recorded, transcribed, independently coded, and then thematically analysed.
Themes that emerged from the interviews centred on patient experiences and perceptions of follow-up service provision and provider interactions related to medical, psychosocial, and lifestyle (e.g., diet, physical activity) care. Many women perceived a marked decline in the quality and duration of follow-up consultations with clinicians in comparison to their initial treatment experiences. Several women experienced considerable overlap in follow-up care when multiple providers were involved resulting in 'unnecessary' time and travel costs. Generally, women experienced limited availability of medical providers in rural areas, resulting in a lack of continuity in care, exacerbated by limited communication and coordination between treating health professionals. Lastly, women perceived a lack of available psychosocial support and resources for rural breast cancer survivors in their areas.
Breast cancer survivors living outside major Australian cities have limited access to medical follow-up care, and psychosocial and lifestyle support programmes. There is a need for greater co-ordination of care between health professionals to improve communication and reduce patient and medical system burden. Finding solutions (such as eHealth options) could help to alleviate these barriers and improve follow-up care for rural breast cancer survivors.
本研究旨在探讨和研究澳大利亚主要城市以外的女性在积极治疗乳腺癌后的随访（医疗和心理社会）的经验和看法。
进行了 25 次半结构化电话访谈。参与者还完成了一份简短的问卷，以收集人口统计学、诊断和治疗信息。采访进行了录音、转录、独立编码，然后进行主题分析。
访谈中出现的主题集中在患者对医疗、心理社会和生活方式（如饮食、身体活动）护理的随访服务提供和提供者互动的经验和看法上。许多女性认为与最初的治疗经历相比，临床医生随访咨询的质量和持续时间明显下降。当涉及多个提供者时，一些女性经历了相当大的随访护理重叠，导致“不必要”的时间和旅行费用。通常，女性在农村地区可获得的医疗提供者有限，导致护理连续性中断，治疗保健专业人员之间的沟通和协调有限加剧了这种情况。最后，女性认为她们所在地区的农村乳腺癌幸存者缺乏可用的心理社会支持和资源。
居住在澳大利亚主要城市以外的乳腺癌幸存者获得医疗随访护理以及心理社会和生活方式支持计划的机会有限。需要加强卫生专业人员之间的护理协调，以改善沟通并减轻患者和医疗系统的负担。寻找解决方案（如电子健康选项）可以帮助缓解这些障碍，并改善农村乳腺癌幸存者的随访护理。
