University of Twente Student Theses


The perception of healthcare professionals regarding the relocation of the follow-up and aftercare of breast cancer from secondary to intermediate care

Karbaat, I.M. (2020) The perception of healthcare professionals regarding the relocation of the follow-up and aftercare of breast cancer from secondary to intermediate care.

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Abstract:Introduction Breast cancer patients and survivors are reporting a range of symptoms after treatment that are detrimental to their Quality of Life. At present, aftercare sub-optimally meets the psychosocial needs of breast cancer patients. Because of this, there is a growing demand for personalised aftercare. Moving the aftercare of breast cancer to a new location outside of the hospital’s breast cancer clinic to deliver specialised care (intermediate care) can ensure better continuity and psychosocial aftercare. The change in location would lower the pressure on the breast cancer clinic, and shift the focus from physical examination to a focus on psychosocial wellbeing. Currently, there is insufficient primary empirical evidence to draw broad conclusions regarding best practice for breast cancer follow-up in intermediate care. This study aimed to gain insight into the perception of healthcare professionals and general practitioners on the relocation of the follow-up and/or aftercare of breast cancer from its current place in the hospital to intermediate care. Method The study focussed on discovering the advantages and disadvantages, perceived barriers, necessities and benefits for the patient, regarding a change in location of the follow-up and aftercare of breast cancer, as seen by the healthcare professionals and GP’s. Participants were healthcare professionals in oncology departments in hospitals and radiotherapeutic institutes participating in the EMBRAZE cancer care network. A representative from the “Nederlandse Huisartsen Genootschap” (NHG) was interviewed for the perspective of the GP’s. The study had an exploratory design and consisted of ten interviews and surveys. Interview data was coded in Atlas.ti. Survey data was analysed using Excel 2019. Results The majority of the respondents mentioned certain conditions have to be met before aftercare could be relocated. Essential factors to consider before aftercare could be relocated were; in-service training for healthcare personnel in intermediate care and a shared EPD. Respondents worried that relocating would not succeed because of the high workload of the GP’s, the volume of patients needed in intermediate care to guarantee quality and the loss of financial resources for the hospital. Considered advantages were; alleviating the burden on the breast cancer clinic, a higher involvement of the patients GP, personalised and nearby aftercare, a cost reduction and less medicalisation of the patient. Respondents are more apprehensive, considering the relocation of the follow-up of breast cancer. The respondents' main worry regarding this change in location was the loss of resources for the hospital. Relocating patients and healthcare professionals to intermediate care would result in a knowledge- and financial loss. Furthermore, respondents mention that patients might be apprehensive regarding the relocating the follow-up since patients seem to prefer contact with an oncologist or surgeon. Conclusion Respondents think the relocation of aftercare would be desirable. However, healthcare professionals do not consider the relocation of the follow-up to be as desirable. To conclude, relocation could be a positive development with positive effects for patients and the healthcare system. Though multiple conditions have to be met before this will be possible, making relocation of breast cancer care a challenge. Further research is needed to create and organise a strong framework for this new intermediate form of breast cancer care.
Item Type:Essay (Bachelor)
Faculty:TNW: Science and Technology
Programme:Health Sciences BSc (56553)
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