Prepared for survivorship? Multidisciplinary healthcare professionals' experiences with adolescents' transition off cancer treatment: A focus group study

Elna Hamilton Larsen; Anneli Viktoria Mellblom; Ellen Ruud; Astrid Klopstad Wahl; Hanne Cathrine Lie

doi:10.1016/j.ejon.2022.102150

Prepared for survivorship? Multidisciplinary healthcare professionals' experiences with adolescents' transition off cancer treatment: A focus group study

Eur J Oncol Nurs. 2022 Jun:58:102150. doi: 10.1016/j.ejon.2022.102150. Epub 2022 May 18.

Authors

Elna Hamilton Larsen¹, Anneli Viktoria Mellblom², Ellen Ruud³, Astrid Klopstad Wahl⁴, Hanne Cathrine Lie⁵

Affiliations

¹ Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Postboks 1111 Blindern, 0317, Oslo, Norway; Department of Paediatric Haematology and Oncology, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Rikshospitalet, Postbox 4950 Nydalen, 0424, Oslo, Norway. Electronic address: e.h.larsen@medisin.uio.no.
² Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Postboks 1111 Blindern, 0317, Oslo, Norway; Regional Centre for Child and Adolescent Mental Health Eastern and Southern Norway (RBUP), Postboks 4623 Nydalen, 0405, Oslo, Norway. Electronic address: anneli.mellblom@r-bup.no.
³ Department of Paediatric Haematology and Oncology, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Rikshospitalet, Postbox 4950 Nydalen, 0424, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Postboks 1111 Blindern, 0317, Oslo, Norway. Electronic address: elruud@ous-hf.no.
⁴ Department of Interdisciplinary Health Sciences, Faculty of Medicine, University of Oslo, Postboks 1089 Blindern, 0317, Oslo, Norway. Electronic address: a.k.wahl@medisin.uio.no.
⁵ Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Postboks 1111 Blindern, 0317, Oslo, Norway. Electronic address: h.c.lie@medisin.uio.no.

PMID: 35653806
DOI: 10.1016/j.ejon.2022.102150

Abstract

Purpose: Research indicates that re-entering everyday life after completed cancer treatment can be challenging for adolescents, and knowledge about how healthcare professionals prepare them is scarce. This study explored (a) healthcare professionals' experiences with adolescents with cancer transitioning off active cancer treatment; and (b) what healthcare professionals' do to prepare adolescents and their families for this transition; and c) their ideas to improve current practice.

Methods: We conducted 8 focus-group interviews with 56 multidisciplinary healthcare professionals working in paediatric oncology settings across Norway. The sample consisted of nurses, physicians, social workers, psychologists, physiotherapists, a nutritionist, a dentist, a teacher and a music therapist. Inductive thematic analyses was used.

Results: We identified three main themes: (a) the multifaceted nature of the end of the treatment phase; (b) navigating challenges in providing early survivorship care; and (c) healthcare professionals' views and wishes regarding their role in transition care. The healthcare professionals conveyed uncertainty regarding how and when to talk about survivorship during treatment. Post-treatment, healthcare professionals' challenges included time restrictions, meeting the families' individual information needs and providing tailored psychosocial care. Suggestions for improvements included checklists, defined roles and dedicated transition consultations.

Conclusions: Healthcare professionals were aware of the challenges families face during transition, and felt many were not addressed adequately. Although they had similar concrete suggestions for improvements, system barriers and lack of time and focus on survivorship were seen to hamper implementation. Implementing a standardized transition programme with increased nurse involvement could potentially improve the transition phase for everyone involved.

Keywords: Adolescent; Childhood cancer survivor; End-of-treatment; Focus groups; Healthcare professionals; Qualitative; Transition.

MeSH terms

Adolescent
Child
Delivery of Health Care
Focus Groups
Health Personnel* / psychology
Humans
Neoplasms* / therapy
Qualitative Research
Survivorship*
Transitional Care*