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Optimizing clinical and organizational practice in cancer survivor transitions between specialized oncology and primary care teams : a realist evaluation of multiple case studies

Tremblay Dominique, Prady Catherine, Bilodeau Karine, Touati Nassera, Chouinard Maud-Christine, Fortin Martin, Gaboury Isabelle, Rodrigue Jean et L'Italien Marie-France. (2017). Optimizing clinical and organizational practice in cancer survivor transitions between specialized oncology and primary care teams : a realist evaluation of multiple case studies. BMC Health Services Research, 17, p. 834.

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URL officielle: https://dx.doi.org/10.1186%2Fs12913-017-2785-z

Résumé

Background : Cancer is now viewed as a chronic disease, presenting challenges to follow-up and survivorship care. Models to shift from haphazard, suboptimal and fragmented episodes of care to an integrated cancer care continuum must be developed, tested and implemented. Numerous studies demonstrate improved care when follow-up is assured by both oncology and primary care providers rather than either group alone. However, there is little data on the roles assumed by specialized oncology teams and primary care providers and the extent to which they work together. This study aims to develop, pilot test and measure outcomes of an innovative risk-based coordinated cancer care model for patients transitioning from specialized oncology teams to primary care providers.

Methods/design : This multiple case study using a sequential mixed-methods design rests on a theory-driven realist evaluation approach to understand how transitions might be improved. The cases are two health regions in Quebec, Canada, defined by their geographic territory. Each case includes a Cancer Centre and three Family Medicine Groups selected based on differences in their determining characteristics. Qualitative data will be collected from document review (scientific journal, grey literature, local documentation), semi-directed interviews with key informants, and observation of care coordination practices. Qualitative data will be supplemented with a survey to measure the outcome of the coordinated model among providers (scope of practice, collaboration, relational coordination, leadership) and patients diagnosed with breast, colorectal or prostate cancer (access to care, patient-centredness, communication, self-care, survivorship profile, quality of life). Results from descriptive and regression analyses will be triangulated with thematic analysis of qualitative data. Qualitative, quantitative, and mixed methods data will be interpreted within and across cases in order to identify context-mechanism associations that explain outcomes.

Discussion : The study will provide empirical data on a risk-based coordinated model of cancer care to guide actions at different levels in the health system. This in-depth multiple case study using a realist approach considers both the need for context-specific intervention research and the imperative to address research gaps regarding coordinated models of cancer care.

Type de document:Article publié dans une revue avec comité d'évaluation
Volume:17
Pages:p. 834
Version évaluée par les pairs:Oui
Date:2017
Sujets:Sciences de la santé
Sciences de la santé > Sciences infirmières
Sciences de la santé > Sciences médicales
Sciences de la santé > Sciences médicales > Oncologie
Département, module, service et unité de recherche:Départements et modules > Département des sciences de la santé > Module des sciences infirmières
Mots-clés:case study, coordination, intervention, mixed methods, primary care, risk-based cancer care, realist evaluation, étude de cas, méthodes mixes, soins primaires, évaluation
Déposé le:12 janv. 2018 01:38
Dernière modification:12 janv. 2018 01:38
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Creative Commons LicenseSauf indication contraire, les documents archivés dans Constellation sont rendus disponibles selon les termes de la licence Creative Commons "Paternité, pas d'utilisation commerciale, pas de modification" 2.5 Canada.

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