Mixed methods scoping review of patients' experiences of urgent and emergency cancer care

Abstract

Background: patients with oncological emergencies require immediate specialist cancer care to ensure optimum outcomes. This is often a stressful, time-sensitive situation for patients and their families who describe having to navigate complex care pathways to access urgent treatment. Acute oncology was established as a subspecialty in the UK in 2009, with the goal to streamline emergency cancer care. Patient experiences of urgent care in acute oncology contexts have not specifically been explored; hence, it is unknown whether patient experiences of emergency cancer care have improved. This may be due to lack of a patient-reported experience measure for this purpose. 

Methods: a mixed methods scoping review was conducted from 2010 to April 2024, with the aim of identifying core aspects of the care experience important to patients with cancer during an acute oncological episode, based on published research evidence. Qualitative, quantitative, and mixed methods articles were sourced and screened in accordance with Joanna Briggs Institute scoping review guidance. Core domains of patient experience were collated and summarised using mixed methods evidence synthesis. 

Results: fifteen articles reporting on 14 unique studies were included. Issues important to patient experiences of emergency cancer care were described by patients, healthcare professional, and carer proxies. Studies captured experiences of various care delivery models including telehealth, in-person presentation to an Emergency Department, and acute oncology services. Six core domains of patient experience arose from the synthesis: managing emotional distress, being treated with compassion and respect, deciding when to seek help, hospital environment, quality of care and communication, and discharge planning. 

Conclusions: this is the first review to identify existing literature on patient experiences of emergency cancer care, highlighting core domains of patient experience impactful for patients and their families. Patients’ decisions about when to seek help and the impact of discussing palliative care needs during an emergency were more specific to emergency cancer care, compared to issues like the hospital environment, which can be important throughout a patient’s cancer care journey. Results will help inform development of a patient-reported experience measure to allow healthcare providers to evaluate and continuously improve specialist urgent and emergency cancer care services.

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