Primary care physicians’ perspectives of the survivorship care for older breast cancer survivors: a pilot study

2019 ◽  
Vol 28 (2) ◽  
pp. 645-652 ◽  
Author(s):  
Jessica L. Krok-Schoen ◽  
Jennifer DeSalvo ◽  
Dori Klemanski ◽  
Christian Stephens ◽  
Anne M. Noonan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Pilot Study ◽  
Cancer Survivors ◽  
Primary Care Physicians ◽  
Breast Cancer Survivors ◽  
Survivorship Care

scholarly journals Survivorship Care Focus Group Discussions for Breast Cancer Survivors and Primary Care Clinicians

2021 ◽  
pp. 1-4
Author(s):  
Hillary Klonoff-Cohen ◽  
Hillary Klonoff-Cohen ◽  
Mounika Polavarapu
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Focus Group ◽  
Cancer Survivors ◽  
Nurse Practitioners ◽  
Late Effects ◽  
Primary Care Physicians ◽  
Breast Cancer Survivors ◽  
Survivorship Care ◽  
Psychological Consequences

Purpose: This is the first pilot study to examine survivors’ experiences and primary care physicians and nurse practitioners’ knowledge and behaviour practices with respect to late effects (e.g., fatigue, chemobrain, lymphodema, cardiac problems, reproductive, infertility and sexual health issues, bone problems, and pain). Methods: Two separate focus groups consisting of 5 breast cancer survivors and 5 primary care physicians and nurse practitioners recruited from a local hospital in Central Illinois answered predetermined questions about cancer survivorship care. We intentionally limited the sample in order to conduct a detailed discussion (90 minutes) to gain every participant’s perspective. Results: Breast cancer survivors expressed a void in discussion and lack of knowledge among their primary care physicians regarding late effects as well as psychological consequences, referrals to support groups, and availability of resources (e.g., finances), thereby negatively affecting survivors’ quality of life. A primary care clinician (PCC) focus group revealed a service gap for mental health services for all patients, knowledge deficit about late effects, and lack of awareness of patient resources. Both cancer survivors and PCCs were extremely supportive about a shared care survivorship model between oncology and primary care. All focus group participants were unequivocally receptive about enhancing survivorship care throughout a cancer survivor’s lifetime. Conclusion: Complementing cancer survivorship care with primary care clinicians in the areas of late effects, in addition to psychological consequences, screening, and lifestyle habits will enhance a cancer survivor’s health-related quality of life.

scholarly journals Perspectives of Survivorship Care Plans Among Older Breast Cancer Survivors: A Pilot Study

2020 ◽  
Vol 27 (1) ◽  
pp. 107327482091720
Author(s):  
Jessica L. Krok-Schoen ◽  
Michelle J. Naughton ◽  
Anne M. Noonan ◽  
Janell Pisegna ◽  
Jennifer DeSalvo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Pilot Study ◽  
Focus Groups ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Survivorship Care Plan ◽  
Survivorship Care ◽  
Care Providers ◽  
Term Care

The Commission on Cancer’s standard 3.3 represents a paradigm shift in the care of cancer survivors, recommending that survivors receive a treatment summary and survivorship care plan (SCPs). A focus on older breast cancer survivors is needed, as they are the majority of the breast cancer population and their experiences and perspectives of SCPs is limited in the literature. This pilot study utilized a mixed methods approach (focus groups and self-report questionnaire data) to gather information on older (≥65 years) breast cancer survivors’ perspectives of their SCPs, cancer survivorship, and communication with their health-care providers. The questionnaire was completed individually by the participants prior to the focus group and contained items on basic demographics and their health status following cancer treatment. The focus groups indicated that only a minority of women actually developed a SCP. Those who developed a SCP in collaboration with their providers valued the personal care and attention received. However, some participants reported poor communication with their providers and within their health-care team, resulting in frustration and confusion. Participants’ suggestions for ideal SCPs included better education and personalization, particularly in appropriate nutrition and exercise, and managing side effects and comorbidities. Lastly, the women believed that additional long-term care resources, such as health coaches, were important in improving their survivorship. These findings provide insight into enhancing the content, communication, and application of SCPs to improve the survivorship experience of older breast cancer survivors.

Primary care physician’s confidence and coordination regarding the survivorship care for older breast cancer survivors

2020 ◽  
Vol 29 (1) ◽  
pp. 223-230
Author(s):  
Christian Stephens ◽  
Dori Klemanski ◽  
Maryam B. Lustberg ◽  
Anne M. Noonan ◽  
Seuli Brill ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Survivorship Care

scholarly journals Roles and recommendations from primary care physicians towards managing low-risk breast cancer survivors in a shared-care model with specialists in Singapore—a qualitative study

2020 ◽  
Vol 37 (4) ◽  
pp. 547-553
Author(s):  
Rose Wai-Yee Fok ◽  
Lian Leng Low ◽  
Hui Min Joanne Quah ◽  
Farhad Vasanwala ◽  
Sher Guan Low ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Cancer Survivors ◽  
Primary Care Physicians ◽  
Breast Cancer Survivors ◽  
Medical Information ◽  
Shared Care ◽  
Cancer Surveillance ◽  
Care Programme ◽  
Care Protocol

Abstract Background Breast cancer is prevalent and has high cure rates. The resultant increase in numbers of breast cancer survivors (BCS) may overwhelm the current oncology workforce in years to come. We postulate that primary care physicians (PCPs) could play an expanded role in comanaging survivors, provided they are given the appropriate tools and training to do so. Objective To explore the perspectives of PCPs towards managing BCS in a community-based shared-care programme with oncologists. Methods Eleven focus groups and six in-depth interviews were conducted with seventy PCPs recruited by purposive sampling. All sessions were audio-recorded, transcribed verbatim and coded by three independent investigators. Thematic data analysis was performed and the coding process facilitated by NVivo 12. Results Majority of PCPs reported currently limited roles in managing acute and non-cancer issues, optimizing comorbidities and preventive care. PCPs aspired to expand their role to include cancer surveillance, risk assessment and addressing unmet psychosocial needs. PCPs preferred to harmonize cancer survivorship management of their primary care patients who are also BCS, with defined role distinct from oncologists. Training to understand the care protocol, enhancement of communication skills, confidence and trust were deemed necessary. PCPs proposed selection criteria of BCS and adequacy of their medical information; increased consultation time; contact details and timely access to oncologists (if needed) in the shared-care programme. Conclusions PCPs were willing to share the care of BCS with oncologists but recommended role definition, training, clinical protocol, resources and access to oncologist’s consultation to optimize the programme implementation.

scholarly journals Breast Cancer Survivors' Perceptions of Survivorship Care Options

2012 ◽  
Vol 30 (2) ◽  
pp. 158-163 ◽  
Author(s):  
Erica L. Mayer ◽  
Adrienne B. Gropper ◽  
Bridget A. Neville ◽  
Ann H. Partridge ◽  
Danielle B. Cameron ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Nurse Practitioners ◽  
Primary Care Physicians ◽  
Breast Cancer Survivors ◽  
Cancer Survival ◽  
Survivorship Care ◽  
Medical Oncologists

Purpose As the number of breast cancer survivors increases, a durable model of comprehensive survivor care is needed, incorporating providers and/or visit types both within and outside of oncology. The objective of this study was to explore survivors' comfort with different clinician types or with a telephone/Internet-based virtual visit as components of survivorship care. Methods Breast cancer survivors participating in a general survivorship survey completed an additional breast cancer–specific questionnaire evaluating the self-perceived impact of follow-up visits to various clinician types, or follow-up by a virtual visit, on survival, worrying, and stress related to cancer. Results A total of 218 breast cancer survivors completed the questionnaire. Most favored medical oncologist follow-up visits over those with primary care physicians (PCPs) or nurse practitioners (NPs) in terms of reduced worrying about cancer (odds ratio [OR], 2.21; P < .001), reduced stress around the visit (OR, 1.40; P = .002), and improved effect on cancer survival (OR, 2.38; P < .001). However, the majority also displayed substantial comfort with both PCPs and NPs in the same domains. Patients rated a virtual visit as having a less favorable impact on cancer survival and cancer-related worrying compared with in-person visits with clinicians. Conclusion Breast cancer survivors are comfortable with both PCPs and NPs providing follow-up care, although they indicate a preference for medical oncologists. Given patients' negative impressions of a virtual visit, increased familiarity with and research investigating this emerging concept are needed. The NP-led survivorship clinic model, with increased guidance for PCPs, offers a promising route for improving quality of and satisfaction with survivor care.

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