Agbejule Oluwaseyifunmi Andi, Joseph Ria, Merchant Sue, Johal Jolyn, Ramsey Imogen, Bender Jacqueline L, Jennings Cally, Osborn Michael, Crawford-Williams Fiona, Chan Raymond J
Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia.
Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Support Care Cancer. 2025 Feb 6;33(3):155. doi: 10.1007/s00520-025-09201-6.
This study aimed to identify challenges and facilitators in accessing cancer care in South Australia, from the perspectives of cancer survivors and caregivers, to inform responsive cancer navigation approaches.
A qualitative descriptive study was conducted using an online qualitative survey (n = 75) and video, phone, and in-person semi-structured interviews (n = 22) with cancer survivors and caregivers (herein cancer consumers). Data analysis was performed in two phases: content analysis categorised consumer challenges and facilitators, while a subjective-inductive approach guided by the supportive care framework was used to develop a statewide navigation approach.
Key challenges reported by consumers included perceived invalidation of medical concerns, delayed diagnoses, poor communication, inadequate information provision, fragmented care, and limited logistical, cultural, and psychological support. Inductive analysis identified four key themes: 1) cancer consumers have dynamic care needs that can evolve throughout a patient's cancer experience, 2) cancer consumers require a foundational level of information to support navigation, 3) some cancer consumers express a preference for community-based navigation services to help them manage their care, and 4) individuals with more complex care needs may require more intensive professional navigation services. A conceptual needs-based navigation approach (the Flinders Needs-Based Approach to Cancer Navigation) was developed based on these insights. This approach consists of three levels of navigation interventions: level 1 involves providing information-based navigation to all individuals affected by cancer, level 2 involves community-based navigation support offered to those requiring or wanting additional supported assistance, and level 3 offers professional navigation for individuals with complex needs.
Our study highlights the importance of tailoring cancer navigation services to meet the evolving needs of patients, emphasising the role of both community and professional support, particularly for individuals with complex care requirements. Findings will inform further co-design discussions involving consumers, health professionals, and policymakers to implement cancer navigation services across South Australia.
本研究旨在从癌症幸存者和护理人员的角度，确定南澳大利亚州在获得癌症护理方面的挑战和促进因素，以为响应式癌症导航方法提供参考。
采用在线定性调查（n = 75）以及与癌症幸存者和护理人员（以下简称癌症患者）进行视频、电话和面对面半结构化访谈（n = 22）的方式开展了一项定性描述性研究。数据分析分两个阶段进行：内容分析对患者面临的挑战和促进因素进行分类，同时采用以支持性护理框架为指导的主观归纳法来制定全州范围的导航方法。
患者报告的主要挑战包括医疗问题被忽视、诊断延迟、沟通不畅、信息提供不足、护理分散以及后勤、文化和心理支持有限。归纳分析确定了四个关键主题：1）癌症患者的护理需求是动态的，会在患者的癌症经历中不断演变；2）癌症患者需要基本水平的信息来支持导航；3）一些癌症患者表示倾向于基于社区的导航服务来帮助他们管理护理；4）护理需求更复杂的个体可能需要更密集的专业导航服务。基于这些见解，开发了一种基于需求的概念性导航方法（弗林德斯基于需求的癌症导航方法）。该方法包括三个级别的导航干预措施：第1级涉及为所有受癌症影响的个体提供基于信息的导航；第2级涉及为那些需要或希望获得额外支持性援助的人提供基于社区的导航支持；第3级为有复杂需求的个体提供专业导航。
我们的研究强调了量身定制癌症导航服务以满足患者不断变化需求的重要性，强调了社区和专业支持的作用，特别是对于有复杂护理需求的个体。研究结果将为涉及患者、卫生专业人员和政策制定者的进一步协同设计讨论提供参考，以在南澳大利亚州实施癌症导航服务。
