Luctkar-Flude M, Aiken A, McColl M A, Tranmer J
School of Nursing, Queen's University, Kingston, ON.
Faculty of Health, Dalhousie University, Halifax, NS.
Curr Oncol. 2018 Jun;25(3):196-205. doi: 10.3747/co.25.3826. Epub 2018 Jun 28.
As cancer centres move forward with earlier discharge of stable survivors of early-stage breast cancer (bca) to primary care follow-up, it is important to address known knowledge and practice gaps among primary care providers (pcps). In the present qualitative descriptive study, we examined the practice context that influences implementation of existing clinical practice guidelines for providing such care. The purpose was to determine the challenges, strengths, and opportunities related to implementing comprehensive evidence-based bca survivorship care guidelines by pcps in southeastern Ontario.
Semi-structured interviews were conducted with 19 pcps: 10 physicians and 9 nurse practitioners.
Thematic analysis revealed 6 themes within the broad categories of knowledge, attitudes, and resources. Participants highlighted 3 major challenges related to providing bca survivorship care: inconsistent educational preparation, provider anxieties, and primary care burden. They also described 3 major strengths or opportunities to facilitate implementation of survivorship care guidelines: tools and technology, empowering survivors, and optimizing nursing roles.
We identified several important challenges to implementation of comprehensive evidence-based survivorship care for bca survivors, as well as several strengths and opportunities that could be built upon to address those challenges. Findings from our research could inform targeted knowledge translation interventions to provide support and education for pcps and bca survivors.
随着癌症中心推动早期乳腺癌(BCA)稳定幸存者更早出院至初级保健随访,解决初级保健提供者(PCP)之间已知的知识和实践差距至关重要。在本定性描述性研究中,我们考察了影响现有临床实践指南实施以提供此类护理的实践背景。目的是确定安大略省东南部PCP实施基于证据的全面BCA生存护理指南相关的挑战、优势和机遇。
对19名PCP进行了半结构化访谈:10名医生和9名执业护士。
主题分析揭示了知识、态度和资源三大类中的6个主题。参与者强调了提供BCA生存护理的3个主要挑战:教育准备不一致、提供者焦虑和初级保健负担。他们还描述了促进生存护理指南实施的3个主要优势或机遇:工具和技术、赋予幸存者权力以及优化护理角色。
我们确定了实施基于证据的全面BCA幸存者生存护理的几个重要挑战,以及可以利用来应对这些挑战的几个优势和机遇。我们研究的结果可为有针对性的知识转化干预措施提供信息,以为PCP和BCA幸存者提供支持和教育。