A study showed colorectal nurse specialists have an important part to play in follow-up care for colorectal cancer patients
In this article…
Exploring patient views of follow-up care following treatment for colorectal cancer
Developing solutions to enhance follow-up care
Kinta Beaver is professor of cancer nursing, school of health, University of Central Lancashire.
Beaver K (2011) Cancer follow-up. Nursing Times; 107: 10, early on-line publication.
This study aimed to explore patient views of follow-up care following treatment for colorectal cancer. Findings from qualitative interviews with patients centred on: “knowing what to expect” after treatment, “living with altered bowel function” and learning by “trial and error”. Colorectal nurse specialists were an important source of information and support. Future strategies for providing follow-up care for these patients should draw on their knowledge and skills.
Keywords: Follow-up clinics, Cancer care, Communication
- This article has been double-blind peer reviewed
Five key points
1. Colorectal nurse specialists have a vital role to play in the follow-up care provided to colorectal cancer patients
2. Follow-up arrangements are not meeting the needs of patients
3. New models of care need to be developed that improve self care, care planning and make the best use of resources and technology
4. Strategies for follow-up care should consider the needs of patients both with and without a stoma
5. Developing web-based information could benefit these patients
After treatment for colorectal cancer, patients are followed-up in hospital outpatient clinics at regular intervals for routine monitoring, aimed at early detection of recurrent disease.The model of follow-up places a strain on the NHS as significant resources need to be employed in delivering this service.
The UK’s National Cancer Survivorship Initiative (NCSI) reports that current follow-up arrangements are not meeting the needs of patients and new models of care need to be developed that improve self care, care planning and make the best use of resources and technology (Department of Health, 2010). Nurse-led models of care could be a way forward.
A systematic review of the effectiveness of nurse-led models of follow-up care reported greater patient well-being and satisfaction (Lewis R et al, 2009). In addition, new modes of service delivery, such as nurse-led telephone follow-up interventions have been shown to be an effective way of providing support and information for cancer patients (Beaver K et al, 2009).
However, little is known about the specific follow-up care experiences of patients who have completed treatment for colorectal cancer. The aim of this study was to explore patient perceptions of their experiences of follow-up care after treatment for colorectal cancer.
This qualitative study explored patient views on follow-up care using face-to-face interviews with a purposive sample of 27 patients (with a mean age of 72 years) who had completed treatment for colorectal cancer. We developed an interview guide to explore issues related to: organisation of follow-up care, satisfaction with follow-up care, personal experience of care, information and advice provided during follow-up care and demographic and disease/ treatment details. Thematic analysis was used to analyse interview transcripts.
One dominant theme (“knowing what to expect”) and three subthemes (“living with altered bowel function”, “trial and error”, “information and support from specialist nurses”) emerged from the data.
Participants wanted more information on what to expect after the completion of treatment. Although they reported attending outpatient clinics, they learnt about their condition through “trial and error”. Participants were supported by colorectal nurse specialists while in hospital undergoing treatment but many reported being left to cope alone once they returned home.
All study participants had attended doctor-led hospital follow-up clinics, while a minority had experienced nurse-led clinics. Nurse-led clinics were perceived as beneficial in providing information and support, particularly on what to expect and what was “normal”. Written information was also well received. Participants would regularly contact colorectal nurse specialists by telephone for information and advice, perceived as helpful in providing both practical and emotional support.
Findings from this study emphasise the important role colorectal nurse specialists play in providing information and support to patients following treatment. Future strategies aimed at providing follow-up care for colorectal cancer patients should draw on their knowledge and skills. Providing continuity of care may prevent minor physical and psychological problems escalating into long term chronic conditions that would be costly to the NHS. Although the study sample was elderly, they still used the internet to access information and further development of web based information could benefit colorectal cancer patients.
This article is a summary of: Beaver K, et al (2010). An exploratory study of the follow-up care needs of patients treated for colorectal cancer. Journal of Clinical Nursing; 19: 23-24, 3291-3330.
Beaver K et al (2009) Comparing hospital and telephone follow-up after treatment for breast cancer: randomised equivalence trial. British Medical Journal; 338: a3147.
Department of Health (2010). The National Cancer Survivorship Initiative Vision. London: Department of Health, Macmillan Cancer Support and NHS Improvement.
Lewis R et al (2009) Nurse-led vs. conventional physician-led follow-up for patients with cancer: systematic review. Journal of Advanced Nursing; 65: 4, 706-723.