According to the cancer survivorship care quality framework, there are five domains which are essential to address cancer survivors’ needs including (1) prevention and surveillance for recurrences and new cancers, (2) surveillance and management of physical effects, (3) surveillance and management of psychosocial effects, (4) surveillance and management of chronic medical conditions, and (5) health promotion and disease prevention. Locally, domains 1 and 4 are being addressed during the routine clinical follow-ups, but there is no systematic approach to address domains 2, 3, and 5. Hence, our cancer survivorship care programme in JCICC focuses to fill the service gaps. Based on the framework for cancer survivorship care quality published recently, we developed a multidisciplinary based cancer survivorship clinic targeting cancer patients at post-treatment survivorship. The multidisciplinary team consists of an APN nurse practitioner, a dietitian, an exercise physiologist and a psychologist/counsellor. During the visit, participants receive a personalized (1) assessment and recommendation on managing physical and psychological symptoms, (2) assessment and recommendation on dietary advice, (3) assessment and recommendation on physical activity, and (4) advice on managing potential psychosocial issues. This 120-minutes survivorship care programme adopts a self-management framework emphasizing the five core skills of problem-solving, decision making , resource utilisation, communication with health care professionals, and action planning.
From September 2019 to December 2019, we had piloted the cancer survivorship care programme in collaboration with the clinical oncology and surgical oncology departments at Queen Mary Hospital. A total of 167 cancer survivors had joined the survivorship care programme. Prior to evaluate the effectiveness of the survivorship care program on patient reported outcomes (e.g. symptom distress, quality of life) and survivors’ health outcomes, it is important to understand patients’ preferences for such survivorship care. In a brief survey distributed to the participants who attended the initial visit, all reported feeling it was worthwhile attending the survivorship clinic, 98% felt the overall time spent at the clinic was about right and 94% stated they would recommend the clinic to other patients. While this reflects the survivorship care program is acceptable, the feedbacks were brief and provided limited insights into cancer patients’ perceptions regarding the usefulness of the survivorship care program in facilitating them to transit from treatment phase to survivorship phase, as well as the challenges patients face in learning and applying the taught skills. Such information will help to optimize the design of the survivorship care intervention and thereby increase its effectiveness.
We are therefore conducting a qualitative study to understand the experience of cancer survivors participating in the cancer survivorship care program and to identify perceptions of barriers and facilitators to learn and apply the taught skills in managing symptom distress and in adopting lifestyle modifications.
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