Cancer Survivorship Research & Care (Jan 2023)
Translating the prostate cancer survivorship essentials framework into clinical practice: a participatory research process analysis
Abstract
Purpose: Accessible cancer survivorship care is a key tenet of quality cancer care. However, prostate cancer survivorship care is often fragmented with best practice models of care largely undefined. The Prostate Cancer Survivorship Essentials Framework (“Essentials Framework”) was developed to guide the provision of integrated quality prostate cancer survivorship care. This process analysis reports the application of the Essentials Framework for mapping a current clinical model of prostate cancer survivorship care and identifying actions to facilitate translation of the framework into clinical practice.Methods: A five-phase mixed-methods participatory research study undertaken in an Australian multi-disciplinary prostate cancer clinic. All occasions of prostate cancer care over a two-year period were extracted from the patient database. Data from online surveys (patients) and semi-structured interviews (service stakeholders) were integrated and mapped to each domain of the Essentials Framework to identify areas of alignment and translational priorities.Results: Data from 326 patients representing 4232 occasions of care, online patient surveys (n = 61) and stakeholder interviews (n = 14) informed the mapping process. There was strong alignment between the service model and Essentials Framework largely due to the co-location of 13 multidisciplinary survivorship care services, and a dedicated focus on continuity of care and clinical surveillance across the prostate cancer survivorship care trajectory. Priority actions for translation included development of integrated survivorship care pathways across all treatment streams, integration of a survivorship care plan into the patient management system and embedding routine distress screening into survivorship care across disciplines. The five study phases formed the basis of a mapping template. This process analysis provides a starting point for services who wish to incorporate the principles of the Essentials Framework into their settings, through explicit description of research methods, tools and processes. An exemplar of mapping outcomes and translational priorities aligned with the Essentials Framework is detailed. This analysis shows the Essentials Framework articulates clearly to current clinical practice and serves as a model to guide the development and evaluation of prostate cancer survivorship care.Conclusions: By adopting a participatory research approach, and prioritizing clinical stakeholder experience, this study demonstrates evidence of the ecological validity of the Essentials Framework. Cross-disciplinary partnerships emerged as critical in identifying service-relevant translational priorities and supporting quality care.
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