Division of Psychosocial Oncology, Department of Oncology, Faculty of Medicine, Cumming School of Medicine, Department of Psychosocial Resources, Tom Baker Cancer Centre, Holy Cross Site, 2202 2nd St. SW, AB, T2S 3C1, Calgary, Canada.
Medical Oncology, Tom Baker Cancer Centre, 1331 29 St. NW, AB, T2N 4N2, Calgary, Canada.
BMC Med Res Methodol. 2022 Mar 6;22(1):64. doi: 10.1186/s12874-022-01549-1.
With advances in cancer diagnosis and treatment, women with early-stage breast cancer (ESBC) are living longer, increasing the number of patients receiving post-treatment follow-up care. Best-practice survivorship models recommend transitioning ESBC patients from oncology-provider (OP) care to community-based care. While developing materials for a future randomized controlled trial (RCT) to test the feasibility of a nurse-led Telephone Survivorship Clinic (TSC) for a smooth transition of ESBC survivors to follow-up care, we explored patients' and OPs' reactions to several of our proposed methods.
We used a qualitative study design with thematic analysis and a two-pronged approach. We interviewed OPs, seeking feedback on ways to recruit their ESBC patients for the trial, and ESBC patients, seeking input on a questionnaire package assessing outcomes and processes in the trial.
OPs identified facilitators and barriers and offered suggestions for study design and recruitment process improvement. Facilitators included the novelty and utility of the study and simplicity of methods; barriers included lack of coordination between treating and discharging clinicians, time constraints, language barriers, motivation, and using a paper-based referral letter. OPs suggested using a combination of electronic and paper referral letters and supporting clinicians to help with recruitment. Patient advisors reported satisfaction with the content and length of the assessment package. However, they questioned the relevance of some questions (childhood trauma) while adding questions about trust in physicians and proximity to primary-care providers.
OPs and patient advisors rated our methods for the proposed trial highly for their simplicity and relevance then suggested changes. These findings document processes that could be effective for cancer-patient recruitment in survivorship clinical trials.
随着癌症诊断和治疗的进步，早期乳腺癌（ESBC）患者的生存期延长，需要接受治疗后随访护理的患者人数增加。最佳实践的生存者模式建议将 ESBC 患者从肿瘤学提供者（OP）护理过渡到基于社区的护理。在为未来的随机对照试验（RCT）开发材料以测试护士主导的电话生存者诊所（TSC）是否可以顺利将 ESBC 幸存者过渡到随访护理的可行性时，我们探讨了患者和 OP 对我们提出的几种方法的反应。
我们使用定性研究设计，采用主题分析和双管齐下的方法。我们采访了 OP，寻求有关招募他们的 ESBC 患者参加试验的方法的反馈，还采访了 ESBC 患者，征求他们对评估试验结果和过程的问卷包的意见。
OP 确定了促进因素和障碍，并提出了关于研究设计和招募过程改进的建议。促进因素包括研究的新颖性和实用性以及方法的简单性；障碍包括治疗和出院临床医生之间缺乏协调、时间限制、语言障碍、动机以及使用纸质转诊信。OP 建议使用电子和纸质转诊信的组合，并支持临床医生进行招募。患者顾问对评估包的内容和长度表示满意。然而，他们对一些问题（儿童期创伤）的相关性提出了质疑，同时增加了关于对医生的信任和与初级保健提供者的接近程度的问题。
OP 和患者顾问对拟议试验的方法评价很高，认为它们简单且相关，然后提出了一些修改建议。这些发现记录了在生存者临床试验中招募癌症患者的有效流程。
