Potential determinants of health-care professionals’ use of survivorship care plans: a qualitative study using the theoretical domains framework

Implementation Science

Deborah K Mayer⁴  Adrian A Gerstel⁴  Shellie D Ellis¹  Justin Presseau²  Sarah A Birken³ 

[1] Department of Health Policy and Management, University of Kansas School of Medicine, Mail Stop 3044, 3901 Rainbow Boulevard, Kansas City 66160, KS, USA;Institute of Health and Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK;Department of Health Policy and Management, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, 1103E McGavran-Greenberg, 135 Dauer Drive, Campus Box 7411, Chapel Hill 27599-7411, NC, USA;School of Nursing, University of North Carolina at Chapel Hill, 2800 Carrington Hall CB# 7460, Chapel Hill 27599, NC, USA

关键词: Theoretical domains framework;    Implementation;    Survivorship care plan;    Health-care professional;    Cancer;   

Others  :  1139486
DOI  :  10.1186/s13012-014-0167-z

 received in 2014-08-18, accepted in 2014-10-30,  发布年份 2014

【 摘 要 】

Background

Survivorship care plans are intended to improve coordination of care for the nearly 14 million cancer survivors in the United States. Evidence suggests that survivorship care plans (SCPs) have positive outcomes for survivors, health-care professionals, and cancer programs, and several high-profile organizations now recommend SCP use. Nevertheless, SCP use remains limited among health-care professionals in United States cancer programs. Knowledge of barriers to SCP use is limited in part because extant studies have used anecdotal evidence to identify determinants. This study uses the theoretical domains framework to identify relevant constructs that are potential determinants of SCP use among United States health-care professionals.

Methods

We conducted semi-structured interviews to assess the relevance of 12 theoretical domains in predicting SCP use among 13 health-care professionals in 7 cancer programs throughout the United States with diverse characteristics. Relevant theoretical domains were identified through thematic coding of interview transcripts, identification of specific beliefs within coded text units, and mapping of specific beliefs onto theoretical constructs.

Results

We found the following theoretical domains (based on specific beliefs) to be potential determinants of SCP use: health-care professionals¿ beliefs about the consequences of SCP use (benefit to survivors, health-care professionals, and the system as a whole); motivation and goals regarding SCP use (advocating SCP use; extent to which using SCPs competed for health-care professionals¿ time); environmental context and resources (whether SCPs were delivered at a dedicated visit and whether a system, information technology, and funding facilitated SCP use); and social influences (whether using SCPs is an organizational priority, influential people support SCP use, and people who could assist with SCP use buy into using SCPs). Specific beliefs mapped onto the following psychological constructs: outcome expectancies, intrinsic motivation, goal priority, resources, leadership, and team working.

Conclusions

Previous studies have explored a limited range of determinants of SCP use. Our findings suggest a more comprehensive list of potential determinants that could be leveraged to promote SCP use. These results are particularly timely as cancer programs face impending SCP use requirements. Future work should develop instruments to measure the potential determinants and assess their relative influence on SCP use.

【 授权许可】

   
2014 Birken et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Siegel R, DeSantis C, Virgo K, Stein K, Mariotto A, Smith T, Cooper D, Gansler T, Lerro C, Fedewa S, Lin C, Leach C, Cannady RS, Cho H, Scoppa S, Hachey M, Kirch R, Jemal A, Ward E: Cancer treatment and survivorship statistics. CA Cancer J Clin 2012, 62:220-241.
• [2]Rechis R, Beckjord EB, Nutt S, Reynolds K, Hayes-Lattin BM: Associations between receipt of a treatment summary, emotional concerns, and patterns of care among post-treatment cancer survivors [abstract]. J Clin Oncol 2012, 30(15):suppl; abstr 9136.
• [3]Blinder VS, Norris VW, Peacock NW, Griggs JJ, Harrington DP, Moore A, Theriault RL, Partridge AH: Patient perspectives on breast cancer treatment plan and summary documents in community oncology care: a pilot program. Cancer 2013, 119(1):164-172.
• [4]Makari-Judson G, Hubbard S, Wrenn T: Use of survivorship care plans to re-engineer breast cancer follow-up. Open Breast Cancer J 2013, 5(1):23-26.
• [5]Nissen MJ, Tsai ML, Blaes AH, Swenson KK, Koering S: Effectiveness of treatment summaries in increasing breast and colorectal cancer survivors' knowledge about their diagnosis and treatment. J Cancer Surviv 2013, 7(2):211-218.
• [6]Faul LA, Rivers B, Shibata D, Townsend I, Cabrera P, Quinn GP, Jacobsen PB: Survivorship care planning in colorectal cancer: feedback from survivors & providers. J Psychosoc Oncol 2012, 30(2):198-216.
• [7]Nissen MJ, Tsai ML, Blaes AH, Swenson KK: Breast and colorectal cancer survivors' knowledge about their diagnosis and treatment. J Cancer Surviv 2012, 6(1):20-32.
• [8]Faul LA, Shibata D, Townsend I, Jacobsen PB: Improving survivorship care for patients with colorectal cancer. Cancer Control 2010, 17(1):35-43.
• [9]Hill-Kayser C, Vachani C, Hampshire M, Di Lullo GA, Metz JM: Positive impact of internet-based survivorship care plans on healthcare and lifestyle behaviors. Int J Radiat Oncol Biol Phys 2012, 84(3):S211-S212.
• [10]Sabatino SA, Thompson TD, Smith JL, Rowland JH, Forsythe LP, Pollack L, Hawkins NA: Receipt of cancer treatment summaries and follow-up instructions among adult cancer survivors: results from a national survey. J Cancer Surviv 2013, 7(1):32-43.
• [11]Birken SA, Deal AM, Mayer DK, Weiner BJ: Determinants of survivorship care plan use in United States cancer programs. J Canc Educ 2014, 29(4):720-727.
• [12]Birken SA, Deal AM, Mayer DK, Weiner BJ: Following Through: The consistency of survivorship care plan use in United States cancer programs. J Cancer Educ 2014, 29(4):689-697.
• [13]Merport A, Lemon SC, Nyambose J, Prout MN: The use of cancer treatment summaries and care plans among Massachusetts physicians. Support Care Cancer 2012, 20:1579-1583.
• [14]Salz T, Oeffinger KC, McCabe MS, Layne TM, Bach PB: Survivorship care plans in research and practice. CA Cancer J Clin 2012, 12:20142.
• [15]Klemp J: Cancer survivorship: a new subspecialty. In ?, Presented at the South Carolina Oncology Society Annual Conference, Fall 2013.
• [16]Birken S, Mayer D, Weiner B: Survivorship care plans: prevalence and barriers to use. J Cancer Educ 2013, 28:290-296.
• [17]Hewitt M, Bamundo A, Day R: Perspectives on post-treatment cancer care: qualitative research with survivors, nurses, and physicians. J Clin Oncol 2007, 25:2270-2273.
• [18][http://www.facs.org/cancer/coc/programstandards2012.pdf] webcite Commission on Cancer: Cancer program standards 2012, version 1.2.1: ensuring patient-centered care. 2/2014 update .
• [19]Ajzen I: The theory of planned behavior. Organ Behav Hum Decis Process 1991, 50:179-211.
• [20]Bandura A: Social cognitive theory: an agentic perspective. Ann Rev Psychol 2001, 52:1-26.
• [21]Michie S, Johnston M, Abraham C, Lawton R, Parker D, Walker A: Making psychological theory useful for implementing evidence based practice: a consensus approach. Qual Saf Health Care 2005, 14:26-33.
• [22]Islam R, Tinmouth AT, Francis JJ, Brehaut JC, Born J, Stockton C, Stanworth SJ, Eccles MP, Cuthbertson BH, Hyde C, Grimshaw JM: A cross-country comparison of intensive care physicians¿ beliefs about their transfusion behaviour: a qualitative study using the theoretical domains framework. Implementation Sci 2012, 7:93. BioMed Central Full Text
• [23]Duncan EM, Francis JJ, Johnston M, Davey P, Maxwell S, McKay GA, McLay J, Ross S, Ryan C, Webb DJ, Bond C: Learning curves, taking instructions, and patient safety: using a theoretical domains framework in an interview study to investigate prescribing errors among trainee doctors. Implementation Sci 2012, 7:86. BioMed Central Full Text
• [24]Boscart VM, Fernie GR, Lee JH, Jaglal SB: Using psychological theory to inform methods to optimize the implementation of a hand hygiene intervention. Implementation Sci 2012, 7:77. BioMed Central Full Text
• [25]Michie S, van Stralen MM, West R: The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci 2011, 6:42. BioMed Central Full Text
• [26]Cane J, O¿Connor D, Michie S: Validation of the theoretical domains framework for use in behaviour change and implementation research. Implement Sci 2012, 7:1748-5908. BioMed Central Full Text
• [27]Francis JJ, Stockton C, Eccles MP, Johnston M, Cuthbertson BH, Grimshaw JM, Hyde C, Tinmouth A, Stanworth SJ: Evidence-based selection of theories for designing behaviour change interventions: using methods based on theoretical construct domains to understand clinicians' blood transfusion behaviour. Br J Health Psychol 2009, 14:625-646.
• [28]Francis JJ, Johnston M, Robertson C, Glidewell L, Entwistle V, Eccles MP, Grimshaw JM: What is an adequate sample size? Operationalising data saturation for theory-based interview studies. Psychol Health 2010, 25:1299-1245.
• [29]Forsythe LP, Parry C, Alfano CM, Kent EE, Leach CR, Haggstrom DA, Ganz PA, Aziz N, Rowland JH: Use of survivorship care plans in the United States: associations with survivorship care. J Natl Cancer Inst 2013, 105:1579-1587.
• [30]Francis JJ, Curran J, O¿Connor D: Article collection: theoretical domains framework for behaviour change research. Implemention Sci 2012, 7:7-9. BioMed Central Full Text