A qualitative study on healthcare professional and patient perspectives on nurse-led virtual prostate cancer survivorship care

Karen Young^{1

2}, Ting Xiong^{1

2}, Kaylen J Pfisterer^{2

3}, Denise Ng², Tina Jiao², Raima Lohani², Caitlin Nunn², Denise Bryant-Lukosius⁴, Ricardo Rendon⁵, Alejandro Berlin⁶, Jacqueline Bender^{1

6

7}, Ian Brown⁸, Andrew Feifer⁹, Geoffrey Gotto¹⁰, Joseph A Cafazzo^{1

2}, Quynh Pham^{11

12

13}

Affiliations

¹ Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.
² Centre for Digital Therapeutics, University Health Network, Toronto, ON, Canada.
³ Systems Design Engineering, University of Waterloo, Waterloo, ON, Canada.
⁴ School of Nursing, McMaster University, Hamilton, ON, Canada.
⁵ Department of Urology, Queen Elizabeth II Health Sciences Centre, Halifax, ON, Canada.
⁶ Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
⁷ Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
⁸ Division of Urology, Niagara Health System, Saint Catharines, ON, Canada.
⁹ Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada.
¹⁰ Division of Urology, University of Calgary, Calgary, AB, Canada.
¹¹ Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada. q.pham@uhn.ca.
¹² Centre for Digital Therapeutics, University Health Network, Toronto, ON, Canada. q.pham@uhn.ca.
¹³ Telfer School of Management, University of Ottawa, Ottawa, ON, Canada. q.pham@uhn.ca.

PMID: 37919491
PMCID: PMC10622495
DOI: 10.1038/s43856-023-00387-6

A qualitative study on healthcare professional and patient perspectives on nurse-led virtual prostate cancer survivorship care

Karen Young et al. Commun Med (Lond). 2023.

. 2023 Nov 2;3(1):159.

doi: 10.1038/s43856-023-00387-6.

Authors

Affiliations

¹ Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.
² Centre for Digital Therapeutics, University Health Network, Toronto, ON, Canada.
³ Systems Design Engineering, University of Waterloo, Waterloo, ON, Canada.
⁴ School of Nursing, McMaster University, Hamilton, ON, Canada.
⁵ Department of Urology, Queen Elizabeth II Health Sciences Centre, Halifax, ON, Canada.
⁶ Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
⁷ Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
⁸ Division of Urology, Niagara Health System, Saint Catharines, ON, Canada.
⁹ Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada.
¹⁰ Division of Urology, University of Calgary, Calgary, AB, Canada.
¹¹ Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada. q.pham@uhn.ca.
¹² Centre for Digital Therapeutics, University Health Network, Toronto, ON, Canada. q.pham@uhn.ca.
¹³ Telfer School of Management, University of Ottawa, Ottawa, ON, Canada. q.pham@uhn.ca.

PMID: 37919491
PMCID: PMC10622495
DOI: 10.1038/s43856-023-00387-6

Abstract

Background: Virtual nurse-led care models designed with health care professionals (HCPs) and patients may support addressing unmet prostate cancer (PCa) survivor needs. Within this context, we aimed to better understand the optimal design of a service model for a proposed nurse-led PCa follow-up care platform (Ned Nurse).

Methods: A qualitative descriptive study exploring follow-up and virtual care experiences to inform a nurse-led virtual clinic (Ned Nurse) with an a priori convenience sample of 10 HCPs and 10 patients. We provide a health ecosystem readiness checklist mapping facilitators onto CFIR and Proctor's implementation outcomes.

Results: We show that barriers within the current standard of care include: fragmented follow-up, patient uncertainty, and long, persisting wait times despite telemedicine modalities. Participants indicate that a nurse-led clinic should be scoped to coordinate care and support patient self-management, with digital literacy considerations.

Conclusion: A nurse-led follow-up care model for PCa is seen by HCPs as acceptable, feasible, and appropriate for care delivery. Patients value its potential to provide role clarity, reinforce continuity of care, enhance mental health support, and increase access to timely and targeted care. These findings inform design, development, and implementation strategies for digital health interventions within complex settings, revealing opportunities to optimally situate these interventions to improve care.

Plain language summary

Prostate cancer (PCa) survivors in Canada receive follow-up care after treatment through a specialist-led model, which is currently straining to meet patient needs. We interviewed healthcare providers (HCPs) and patients to investigate the design and development of a healthcare service that uses technology, also known as virtual care, to provide nurse-led follow-up care. Mixed experiences with virtual care informed participant feedback and concerns, including impacts of the pandemic and digital literacy considerations. We show that HCPs and patients see potential benefit in virtual nurse-led follow-up care if it can increase access to resources, clarify patient and provider care roles, and improve access and continuity of care. This type of approach to follow-up care may help to improve survivor quality of life and PCa follow-up care while extending the reach of healthcare systems with limited resources.

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Conflict of interest statement

The authors declare the following competing interests: Q.P., J.A.C., A.B., A.F. and University Health Network jointly own intellectual property rights to the Ned platforms (including Ned Nurse). Under the respective agreements with their organizations, these individuals are entitled to personally benefit from any commercial use of the intellectual property. The other authors declare no competing interests.

References

1. SEER. Cancer of the prostate - cancer stat facts. https://seer.cancer.gov/statfacts/html/prost.html.
1. Canadian Cancer Statistics Advisory Committee in collaboration with the Canadian Cancer Society, Statistics Canada & the Public Health Agency of Canada. Canadian cancer statistics 2021. http://cancer.ca/Canadian-Cancer-Statistics-2021-EN (2021).
1. Mason RJ, et al. UPDATE − 2022 Canadian Urological Association recommendations on prostate cancer screening and early diagnosis. Endorsement of the 2021 Cancer Care Ontario guidelines on prostate multiparametric magnetic resonance imaging. Can. Urol. Assoc. J. 2022;16:E184–E196. doi: 10.5489/cuaj.7851. - DOI - PMC - PubMed
1. Parker C, et al. Prostate cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann. Oncol. 2020;31:1119–1134. doi: 10.1016/j.annonc.2020.06.011. - DOI - PubMed
1. Matthew A, et al. The Prostate Cancer Rehabilitation Clinic: a biopsychosocial clinic for sexual dysfunction after radical prostatectomy. Curr. Oncol. 2018;25:393–402. doi: 10.3747/co.25.4111. - DOI - PMC - PubMed

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A qualitative study on healthcare professional and patient perspectives on nurse-led virtual prostate cancer survivorship care

Affiliations

A qualitative study on healthcare professional and patient perspectives on nurse-led virtual prostate cancer survivorship care

Authors

Affiliations

Abstract

Plain language summary

Conflict of interest statement

References

Grants and funding

LinkOut - more resources

Full Text Sources