Does telephone aftercare meet psychosocial needs?

Abstract

BACKGROUND: The National Cancer Survivorship Initiative in the UK calls for a shift from the traditional medical model of hospital followup for people with cancer. We conducted randomised controlled trials (RCT) which demonstrated that telephone aftercare by specialist nurses is beneficial in breast and colorectal cancer, shifting the focus from searching for signs of recurrent disease to meeting the information and support needs of patients using a structured telephone intervention. The RCTs provided evidence of effectiveness, whilst qualitative studies allowed indepth analysis of how the intervention worked and its impact.

METHODS: Interviews were conducted which aimed to explore experiences of telephone aftercare with 54 patients, 28 with breast, 26 with colorectal cancer and 5 specialist nurses; all had either received or delivered telephone aftercare. Data were analysed using content analysis.

RESULTS: All patients liked telephone aftercare. The structure of the intervention instilled confidence, patients reported that all relevant questions had been asked and answered with nothing "missed". Patients felt telephone aftercare was convenient, economical and more "normal" than hospital follow-up, providing continuity of care and carer. Specialist nurses reported the high level of skill, knowledge and confidence required to deliver the intervention and, perceived that, unlike hospital outpatient care, telephone aftercare met individual needs and supported patient self-management.

CONCLUSIONS: Useful insights were gained into how the intervention could be implemented into everyday clinical practice. Moreover these studies demonstrated that meeting psycho-social needs is essential to help patients who have survived a cancer diagnosis and treatment to self-manage.