Exploring the perspectives of significant others on patients’ experiences of cancer services

Abstract

Background and objective: Globally, there has been a growing concern that patients are not receiving appropriate cancer care based on their needs. Whilst efforts were made towards better quality of care to meet patients’ expectations, healthcare systems are required to operate with decreasing resources given the overall economic context. This study aimed to explore the perspectives of significant others regarding cancer care experiences of patients receiving antineoplastic medicines for colorectal cancer. Method: A longitudinal design was adopted over a six-month period. Individuals initiating treatment for colorectal cancer with either FOLFOX for 12 cycles or XELOX for 8 cycles at the national oncology centre in Malta were asked to nominate at least one significant other; that is a person who in their opinion was highly involved in their care. Two in-depth interviews with significant others were conducted at patient’s initiation and completion of treatment (24 weeks interval), transcribed verbatim and thematically analysed. Main outcome measures: Themes illustrating perspectives of significant others regarding patients’ experiences. Results: A total of 16 participants, were interviewed [females (n = 12) and spouses (n = 6)]. Three themes were identified: (1) patients’ experiences of cancer services (2) healthcare professionals’ communication with patients and others (3) recommendations for services. Whilst significant others noted that patients were overall satisfied with cancer services throughout the treatment journey, negative experiences were mainly related to misdiagnosis. The issue of being truthful about cancer diagnosis raised different opinions, with some considering that complete disclosure was insensitive. Some argued that healthcare professionals were directly answering patients’ questions without further expansion. This was irrespective of the patients’ lack of knowledge and ability to ask further questions. At initiation of treatment, significant others recommended the need for improved awareness of available support services such as psychological services and more regular contact time with healthcare professionals. At completion of treatment, recommendations shifted to availability of cancer care services in the community setting including provision of ambulatory care. Conclusion: This study showed that timeliness of diagnosis and accessibility to healthcare services were crucial in cancer care. Introduction of interventions along the treatment journey to address the patients’ current needs were recommended and ‘‘one size fits all’’ approach is not suitable.