An exploratory study of the follow-up care needs of patients treated for colorectal cancer

Abstract

Background.  The optimal follow-up strategy for colorectal cancer is not known, and although patients are seen in traditional outpatient follow-up clinics, this system may not meet psycho-social and information needs.

Design.  An exploratory qualitative study.

Method.  In-depth interviews were conducted with 27 patients who had completed treatment for colorectal cancer. The data were analysed using thematic analysis.

Results.  One dominant theme emerged from the data with several sub-themes. The dominant theme was ‘knowing what to expect’ after bowel surgery. The subthemes related to ‘living with altered bowel function’, the ways patients gathered information about their condition through ‘trial and error’ and ‘information and support from specialist nurses’. Patients who did not have a stoma were particularly vulnerable and expressed a need for more information on knowing what to expect after surgery. The role of the colorectal nurse specialist was vital in providing information and support; in particular, nurse-led clinics provided continuity of care and information that was tailored to individual need.

Conclusions.  Traditional hospital follow-up does not always address patients’ psycho-social and information needs. Nurse-led services were commented on favourably in terms of providing information that was tailored to individual need as well as being responsive to urgent patient concerns; future innovative strategies for providing follow-up care for patients with colorectal cancer should draw on the specialist knowledge and skills of these nurses.

Relevance to clinical practice.  Nurse-led clinics and/or telephone follow-up by specialist nurses may be effective models of care for this particular patient group, providing appropriate access for meeting clinical, psycho-social and information needs.