McErlean Gemma, Ashley Christine, Pradhan Anisha, Yenson Vanessa, Kerridge Ian, Halcomb Elizabeth
School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, NSW, Australia.
Health Innovations, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, NSW, Australia.
Support Care Cancer. 2025 Jun 5;33(7):544. doi: 10.1007/s00520-025-09577-5.
Survivors of blood and marrow transplant (BMT) for malignancies experience significant morbidity and mortality resulting from the long-term and late effects of transplant, necessitating life-long care. The purpose of this study was to explore the perceptions of specialist BMT advanced practice nurses (APNs), physicians, and primary care practitioners regarding the challenges of delivering long-term care for survivors of BMT.
This descriptive qualitative study used semi-structured interviews with 13 purposefully selected healthcare professionals (HCPs) experienced in providing long-term care to survivors of BMT. Data were analysed using thematic analysis.
Two themes were identified: (1) prioritising patient-centred care and (2) equity and access to services. Prioritising patient-centred care included the sub-themes of (a) the burden of survivorship and complexity of long-term care, (b) education and preparation for long-term follow-up, and (c) adherence with long-term follow-up care. Equity and access included the four sub-themes of, (a) the tyranny of distance, (b) the price of survival, (c) primary care and the availability of GPs, and (d) access to appropriate long-term care.
HCPs need to adopt patient-centred strategies to improve optimal care and equity for long-term BMT survivors. Practical approaches include providing comprehensive education and personalised care, performing routine needs assessments, implementing flexible models of care that integrate primary care such as shared care and telehealth. Using digital health platforms and advocating for reduced financial barriers can further address challenges in access and equity. These efforts have the potential to enhance long-term care delivery, improve outcomes, and ultimately enhance quality of life for BMT survivors.
恶性肿瘤血液和骨髓移植（BMT）幸存者由于移植的长期和晚期影响，经历了显著的发病率和死亡率，因此需要终身护理。本研究的目的是探讨专业BMT高级实践护士（APN）、医生和初级保健从业者对为BMT幸存者提供长期护理挑战的看法。
这项描述性定性研究采用半结构化访谈，对13名经过有目的选择、在为BMT幸存者提供长期护理方面经验丰富的医疗保健专业人员（HCP）进行了访谈。使用主题分析法对数据进行了分析。
确定了两个主题：（1）以患者为中心的护理优先事项和（2）服务的公平性和可及性。以患者为中心的护理优先事项包括以下子主题：（a）生存负担和长期护理的复杂性，（b）长期随访的教育和准备，以及（c）坚持长期随访护理。公平性和可及性包括四个子主题：（a）距离的限制，（b）生存的代价，（c）初级保健和全科医生的可及性，以及（d）获得适当的长期护理。
医疗保健专业人员需要采用以患者为中心的策略，以改善长期BMT幸存者的最佳护理和公平性。实际方法包括提供全面的教育和个性化护理、进行常规需求评估、实施整合初级保健的灵活护理模式，如共享护理和远程医疗。使用数字健康平台并倡导减少经济障碍，可以进一步解决可及性和公平性方面的挑战。这些努力有可能加强长期护理服务的提供，改善结果，并最终提高BMT幸存者的生活质量。
