Refocusing cancer supportive care: a framework for integrated cancer care
Details
Publication Year 2023,Volume 31,Issue #1,Page 14
Journal Title
Supportive Care in Cancer
Publication Type
Research article
Abstract
OBJECTIVE: Cancer supportive care comprises an integrative field of multidisciplinary services necessary for people affected by cancer to manage the impact of their disease and treatment and achieve optimal health outcomes. The concept of supportive care, largely driven by Margaret Fitch's seminal supportive care framework, was developed with the intent to provide health service planners with a conceptual platform to plan and deliver services. However, over time, this concept has been eroded, impacting implementation and practice of supportive care. This study therefore aimed to examine expert contemporary views of supportive care with the view to refocusing the definition and conceptual framework of cancer supportive care to enhance relevance to present-day cancer care. METHODS: A two-round online modified reactive Delphi survey was employed to achieve consensus regarding terminology to develop a contemporary conceptual framework. A listing of relevant cancer supportive care terms identified through a scoping review were presented for assessment by experts. Terms that achieved >/= 75% expert agreement as 'necessary' were then assessed using Theory of Change (ToC) to develop consensus statements and a conceptual framework. RESULTS: A total of 55 experts in cancer control with experience in developing, advising on, delivering, or receiving supportive care in cancer took part in the Delphi surveys. Expert consensus assessed current terminology via Delphi round 1, with 124 terms deemed relevant and 'necessary' per pre-specified criteria. ToC was applied to consensus terms to develop three key statements of definition, and a comprehensive conceptual framework, which were presented for expert consensus review in Delphi round 2. CONCLUSION: Finalised definitions and conceptual framework are strongly aligned with relevant international policy and advocacy documents, and strengthen focus on early identification, timely intervention, multidisciplinary collaboration, and end-to-end, cross-sector, cancer supportive care.
Publisher
Springer Nature
Keywords
Humans; Delphi Technique; Consensus; *Neoplasms/therapy; Health Services; Cancer; Conceptual framework; Definitions; Health system; Supportive care
Department(s)
Academic Nursing; Health Services Research
PubMed ID
36513841
Open Access at Publisher's Site
https://doi.org/10.1007/s00520-022-07501-9
Terms of Use/Rights Notice
Refer to copyright notice on published article.


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