Charlotte Handberg1, Sally Thorne2, Thomas Maribo3. 1. Department of Public Health, Section for Clinical Social Medicine and Rehabilitation, Faculty of Health, Aarhus University, Denmark and DEFACTUM, Central Denmark Region, Denmark. Electronic address: Charlotte.handberg@stab.rm.dk. 2. School of Nursing, University of British Columbia, Vancouver, Canada. 3. Department of Public Health, Section for Clinical Social Medicine and Rehabilitation, Faculty of Health, Aarhus University, Denmark and DEFACTUM, Central Denmark Region, Denmark.
Abstract
PURPOSE: To analyze and describe health professionals' attitudes and perspectives on the complexities of cancer survivorship and rehabilitation needs assessment in a shared cancer care context. METHOD: The design and methodology for this study was Interpretive Description and the analysis was informed by Symbolic Interactionism as the theoretical framework. Between April and December 2015 an ethnographic fieldwork was carried out by the first author in haematological wards at two Danish hospitals and in two primary care settings conducting cancer survivorship care programs. Participants were 41 health professionals working with needs assessment. RESULTS: The findings revealed an understanding of the health professionals' attitudes and perspectives and were distinguishable in relation to three structural conditions associated with the dimensions of survivorship care: Patient Context, Workplace Priorities and Practice Culture. Despite shared beliefs that needs assessment was essential to ensure survivorship care, the differential conditions surrounding the hospital and the primary care settting impeded the wider idea of formalized needs assessment, creating barriers to a seamless link between the sectors. CONCLUSIONS: Meaningful resolution of these disjunctures will require broad solutions, recognizing that the organization of healthcare into disconnected systems, with their different conditions, history, habits and traditions, will certainly plague the "transition" problems in healthcare unless a wider perspective is taken. Thoughtful and informed clinicians working with decision makers and those who know the evidence and can interpret systems in context can certainly bring better options to light in order to develop high quality survivorship care that will support patients throughout their cancer trajectory.
PURPOSE: To analyze and describe health professionals' attitudes and perspectives on the complexities of cancer survivorship and rehabilitation needs assessment in a shared cancer care context. METHOD: The design and methodology for this study was Interpretive Description and the analysis was informed by Symbolic Interactionism as the theoretical framework. Between April and December 2015 an ethnographic fieldwork was carried out by the first author in haematological wards at two Danish hospitals and in two primary care settings conducting cancer survivorship care programs. Participants were 41 health professionals working with needs assessment. RESULTS: The findings revealed an understanding of the health professionals' attitudes and perspectives and were distinguishable in relation to three structural conditions associated with the dimensions of survivorship care: Patient Context, Workplace Priorities and Practice Culture. Despite shared beliefs that needs assessment was essential to ensure survivorship care, the differential conditions surrounding the hospital and the primary care settting impeded the wider idea of formalized needs assessment, creating barriers to a seamless link between the sectors. CONCLUSIONS: Meaningful resolution of these disjunctures will require broad solutions, recognizing that the organization of healthcare into disconnected systems, with their different conditions, history, habits and traditions, will certainly plague the "transition" problems in healthcare unless a wider perspective is taken. Thoughtful and informed clinicians working with decision makers and those who know the evidence and can interpret systems in context can certainly bring better options to light in order to develop high quality survivorship care that will support patients throughout their cancer trajectory.
Authors: Bróna Nic Giolla Easpaig; Yvonne Tran; Mia Bierbaum; Gaston Arnolda; Geoff P Delaney; Winston Liauw; Robyn L Ward; Ian Olver; David Currow; Afaf Girgis; Ivana Durcinoska; Jeffrey Braithwaite Journal: BMC Health Serv Res Date: 2020-02-10 Impact factor: 2.655