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Perspectives on Post-Treatment Cancer Care: Qualitative Research With Survivors, Nurses, and Physicians

Maria E. Hewitt, Annette Bamundo, Rebecca Day, Catherine Harvey

From the Institute of Medicine, The National Academies, Washington, DC; Bamundo Qualitative Research, Brooklyn, NY; Kinzey & Day Market Research, Richmond, VA; and The Oncology Group LLC, Raleigh, NC

Address reprint requests to Maria Hewitt, 885 Oliver St, Victoria, British Columbia, Canada V8S 4W5; e-mail: Maria.hewitt{at}gmail.com

Purpose: Cancer survivors have many medical and psychosocial needs that are unaddressed in the post-treatment period. Qualitative research was carried out to assess how a survivorship care plan created by oncologists could improve the quality of survivorship care.

Participants and Methods: Focus groups and interviews conducted with cancer survivors, nurses, primary care physicians, and oncologists provide insights into post-treatment follow-up practices and the acceptability and feasibility of providing survivors and referring physicians with a cancer survivorship care plan.

Results: Cancer survivors reported satisfaction with post-treatment medical care, but felt that their psychosocial needs were not met. Survivors expressed enthusiastic support for receipt of a follow-up care plan. Primary care physicians viewed themselves as playing an important role during the post-treatment period and indicated that a written care plan for follow-up would help them improve their survivorship practices. Nurses recognized the need to improve the care of cancer survivors and suggested that they could play an active role in creating and implementing cancer survivorship plans. Physicians providing oncology care acknowledged the value of survivorship care plans, but were not inclined to complete them because such plans would not reduce other reporting and communication requirements and would be burdensome to complete given their busy schedules.

Conclusion: Survivorship care planning is viewed favorably by consumers, nurses, and physicians, however there are several barriers to its adoption. Barriers may be overcome with: electronic medical records, changes in reporting requirements of insurers, advocacy on the part of patients, and incorporation of care planning in education and training programs.

Supported by the Lance Armstrong Foundation, the National Coalition for Cancer Survivorship, and the National Cancer Institute.

Qualitative research results were presented in part at an Institute of Medicine Workshop (IOM), May 15, 2006 (A.B., R.D., C.H.). These presentations were summarized in an IOM workshop summary published by the National Academies Press.

The analysis, opinions, and assertions contained herein are those of the author and are not to be construed as reflecting the views or position of the National Academy of Sciences, the Institute of Medicine, or the National Research Council.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.