Providers and recipients of breast cancer follow-up : addressing needs and optimising service delivery

Pennery, Emma (2005) Providers and recipients of breast cancer follow-up : addressing needs and optimising service delivery. University of Southampton, Doctoral Thesis.

Record type: Thesis (Doctoral)

Abstract

Increasing numbers of people attend follow-up after treatment for breast cancer. This constitutes a significant workload and involves costly and time-consuming procedures with questionable, undefined efficacy. Conflicting opinions exist among professionals with regard to the duration and purpose of follow-up. Breast cancer can be conceptualised as a chronic disease where people have multiple needs that change over time. Nevertheless, the current system is traditionally routinised and lacks an individualised approach. There is no evidence that the practice of follow-up is associated with a more favourable prognosis or improved well-being and very little data exists on its effects on health related quality of life.

Opportunities for change lie in formulating a more effective intervention. There were three phases to this study, using multiple methods. The first phase ascertains women’s perceptions of follow-up care using semi-structured, taped interviews and qualitative analysis. The second phase describes a focus group held with doctors who regularly provide follow-up to explore and describe their views. The third phase consists of a randomised-controlled trial designed to establish the benefits resulting form nurse-led or medical follow-up. The findings contribute to knowledge of caring for people attending for breast cancer follow-up in several ways. Firstly by eliciting the views of users and providers to ensure compatibility between their collective needs and perceptions. Secondly by clearly identifying specific areas requiring improvement. Thirdly by making recommendations for future research as well as restructuring of breast cancer follow-up to facilitate optimum care in the future.

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