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      Aboriginal and Torres Strait Islander patients’ cancer care pathways in Queensland: Insights from health professionals

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          Abstract

          Objective

          To identify points for improvements within the health system where Aboriginal and Torres Strait Islander cancer patients may experience a lack of continuity in their cancer care. The optimal care pathway for Aboriginal and Torres Strait Islander people with cancer (OCP) framework was utilised as a tool in this work.

          Methods

          Semi‐structured interviews were conducted with health professionals at the primary health care (PHC) and hospital setting. Data were categorised into six steps using the OCP framework.

          Results

          This study identified multiple time‐points in the cancer pathways that could be strengthened to increase the continuity of cancer care for these patients. In addition, the provision of person‐centred care and adequate education tailored to patients' and health professionals' needs can help minimise the likelihood of patients experiencing a lack of continuity in their cancer care. Participants were recruited from an urban hospital (n = 9) and from six Aboriginal Community Controlled Health Services (n = 17) across geographical locations in Queensland. The provision of culturally competent care, effective communication, coordination and collaboration between services along the cancer pathway from prevention and early diagnosis through to end‐of‐life care were highlighted as important to enhance care continuity for Indigenous Australians.

          Conclusion

          The implementation of recommendations outlined in the OCP framework may help with improving cancer care continuity for Indigenous patients with cancer.

          Summary

          Aboriginal and Torres Strait Islander people can sometimes find cancer care pathways complex and difficult to navigate. This study identified points in the cancer pathways that could be strengthened to increase the continuity of cancer care for these patients which could potentially lead to improved outcomes.

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          Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

          A Tong, P SAINSBURY, J. Craig (2007)
          Qualitative research explores complex phenomena encountered by clinicians, health care providers, policy makers and consumers. Although partial checklists are available, no consolidated reporting framework exists for any type of qualitative design. To develop a checklist for explicit and comprehensive reporting of qualitative studies (in depth interviews and focus groups). We performed a comprehensive search in Cochrane and Campbell Protocols, Medline, CINAHL, systematic reviews of qualitative studies, author or reviewer guidelines of major medical journals and reference lists of relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Duplicate items and those that were ambiguous, too broadly defined and impractical to assess were removed. Items most frequently included in the checklists related to sampling method, setting for data collection, method of data collection, respondent validation of findings, method of recording data, description of the derivation of themes and inclusion of supporting quotations. We grouped all items into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. The criteria included in COREQ, a 32-item checklist, can help researchers to report important aspects of the research team, study methods, context of the study, findings, analysis and interpretations.
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            Saturation in qualitative research: exploring its conceptualization and operationalization

            Benjamin Saunders, Julius Sim, Tom Kingstone … (2017)
            Saturation has attained widespread acceptance as a methodological principle in qualitative research. It is commonly taken to indicate that, on the basis of the data that have been collected or analysed hitherto, further data collection and/or analysis are unnecessary. However, there appears to be uncertainty as to how saturation should be conceptualized, and inconsistencies in its use. In this paper, we look to clarify the nature, purposes and uses of saturation, and in doing so add to theoretical debate on the role of saturation across different methodologies. We identify four distinct approaches to saturation, which differ in terms of the extent to which an inductive or a deductive logic is adopted, and the relative emphasis on data collection, data analysis, and theorizing. We explore the purposes saturation might serve in relation to these different approaches, and the implications for how and when saturation will be sought. In examining these issues, we highlight the uncertain logic underlying saturation—as essentially a predictive statement about the unobserved based on the observed, a judgement that, we argue, results in equivocation, and may in part explain the confusion surrounding its use. We conclude that saturation should be operationalized in a way that is consistent with the research question(s), and the theoretical position and analytic framework adopted, but also that there should be some limit to its scope, so as not to risk saturation losing its coherence and potency if its conceptualization and uses are stretched too widely.
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              Deficits in communication and information transfer between hospital-based and primary care physicians: implications for patient safety and continuity of care.

              Sunil Kripalani, Frank Lefèvre, Christopher Phillips … (2007)
              Delayed or inaccurate communication between hospital-based and primary care physicians at hospital discharge may negatively affect continuity of care and contribute to adverse events. To characterize the prevalence of deficits in communication and information transfer at hospital discharge and to identify interventions to improve this process. MEDLINE (through November 2006), Cochrane Database of Systematic Reviews, and hand search of article bibliographies. Observational studies investigating communication and information transfer at hospital discharge (n = 55) and controlled studies evaluating the efficacy of interventions to improve information transfer (n = 18). Data from observational studies were extracted on the availability, timeliness, content, and format of discharge communications, as well as primary care physician satisfaction. Results of interventions were summarized by their effect on timeliness, accuracy, completeness, and overall quality of the information transfer. Direct communication between hospital physicians and primary care physicians occurred infrequently (3%-20%). The availability of a discharge summary at the first postdischarge visit was low (12%-34%) and remained poor at 4 weeks (51%-77%), affecting the quality of care in approximately 25% of follow-up visits and contributing to primary care physician dissatisfaction. Discharge summaries often lacked important information such as diagnostic test results (missing from 33%-63%), treatment or hospital course (7%-22%), discharge medications (2%-40%), test results pending at discharge (65%), patient or family counseling (90%-92%), and follow-up plans (2%-43%). Several interventions, including computer-generated discharge summaries and using patients as couriers, shortened the delivery time of discharge communications. Use of standardized formats to highlight the most pertinent information improved the perceived quality of documents. Deficits in communication and information transfer at hospital discharge are common and may adversely affect patient care. Interventions such as computer-generated summaries and standardized formats may facilitate more timely transfer of pertinent patient information to primary care physicians and make discharge summaries more consistently available during follow-up care.
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                Author and article information

                Contributors
                Journal
                Title: Health Promotion Journal of Australia
                Abbreviated Title: Health Prom J of Aust
                Publisher: Wiley
                ISSN (Print): 1036-1073
                ISSN (Electronic): 2201-1617
                Publication date Created: July 2022
                Publication date (Electronic): November 18 2021
                Publication date (Print): July 2022
                Volume: 33
                Issue: 3
                Pages: 701-710
                Affiliations
                [1 ] Menzies School of Health Research Brisbane QLD Charles Darwin University Darwin NT Australia
                [2 ] QIMR Berghofer Medical Research Institute Brisbane QLD Australia
                [3 ] Institute of Health and Biomedical Innovation Queensland University of Technology Brisbane QLD Australia
                [4 ] University Centre for Rural Health University of Sydney Sydney NSW Australia
                [5 ] Southside Clinical School University of Queensland Brisbane QLD Australia
                [6 ] Faculty of Health University of Technology Sydney Sydney NSW Australia
                [7 ] School of Medicine and Public Health University of Newcastle Newcastle NSW Australia
                Article
                DOI: 10.1002/hpja.556
                SO-VID: 9a521835-b031-44d2-b642-b5b0287c10fc
                Copyright © © 2022
                License:

                http://onlinelibrary.wiley.com/termsAndConditions#vor

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