Date of Award

2018

Degree Name

Doctor of Philosophy (College of Nursing)

Schools and Centres

Nursing and Midwifery

First Supervisor

Professor Leanne Monterosso

Second Supervisor

Associate Professor Caroline Bulsara

Abstract

Background: Cancer survivorship is recognised as an integral component of the cancer continuum. Robust evidence on how best to deliver tailored survivorship care is limited, particularly for individuals affected by rarer cancers such as lymphoma, a potentially curable haematological cancer. These survivors may face long-term and late effects affecting quality of life due to the aggressiveness of the disease and treatment that may not be adequately addressed in current follow-up models of care.

Aim: To develop and pilot test a nurse-led model of survivorship care intervention that utilises an individualised survivorship care plan and treatment summary (SCPTS), motivational interviewing, tailored support and resources with lymphoma patients who have completed active treatment.

Method: A four-phase prospective study was undertaken: Phase One consisted of integrative/systematic reviews; Phase Two focused on development of the survivorship model of care; Phase Three comprised a pragmatic randomised controlled trial (RCT) to test the intervention; and Phase Four elicited qualitative feedback from intervention participants and their general practitioners’ (GP). A published pilot pragmatic RCT protocol was implemented and participants were randomised to a control group (n=30) or intervention group (n=30). Four patient reported outcome measures were administered to both groups at three time points; baseline (Time 1), 3 months (Time 2) and six months (Time 3).

Data Analysis: Descriptive, univariate and multivariate statistical techniques were applied to quantitative data. Content analysis was performed on qualitative interview data and GP evaluations.

Results: Three comprehensive integrative/systematic reviews were undertaken, published (survivorship models of care, SCPTS, survivorship needs assessment measures) and informed the development of a unique and concise evidence-based SCPTS and other model of care (intervention) components. The intervention comprised three face-to-face appointments over six months to deliver the lymphoma survivorship model of care. Intervention participants reported increased self-empowerment and less unmet needs. Test–retest reliability analysis was performed and published for the Short-Form Survivor Unmet Needs Survey (n=40). Ten intervention participants interviewed at completion of the RCT reported a positive experience of the model of care. Feedback from 18/28 (64%) GPs confirmed the SCPTS was a useful tool for patient consultations.

Conclusion: Findings add to a limited body of knowledge in lymphoma survivorship care and nurse-led models of care. They highlight the importance and perceived value of providing individualised, tailored support to lymphoma survivors from treatment completion. The evidence produced from this study provides baseline data to support future rigorous testing of nurse-led models of lymphoma survivorship care with larger samples.

Download Complete Thesis
Files over 3MB may be slow to open. For best results, right-click and select "save as..."

Download by Chapter

Included in

Nursing Commons

Share

COinS