Background: Coordinating cancer care can prove especially challenging because of the complexity of both the disease and its treatment. Typically, the care of cancer patients involves multiple types of therapies and providers (surgery, radiation therapy, chemotherapy) and ongoing treatment of cancer and other health conditions. Cancer care coordination depends upon effective, regular communication among physicians, support staff, and the patient. The objective of this study is to explore veteran patients’ experiences of cancer care coordination in order to develop a deeper understanding of the issues veterans consider important and actionable.
Methods: Semi-structured interviews were conducted among patients diagnosed with cancer types and stages that commonly receive inter-disciplinary care (eg, colorectal [stage II and up], prostate [high risk], head and neck [all stages], and lung [all stages] cancer) were eligible to participate in the study. The constant comparison technique was used to identify emerging themes.
Results: Twenty-five veteran cancer patients participated in this study. Our analysis identified four general categories representing different parts of the trajectory of the patient cancer care experience in need of coordination. Each phase had a distinct set of needs and challenges. Diagnosis: After receiving a diagnosis of cancer, Veterans reported initial feelings of shock and fear. Pre-Treatment: This phase was characterized as busy and chaotic, consisting of many appointments in different locations, and ultimately left many veterans feeling a lack of control. Onset of Treatment: Uncertainty about what to expect when receiving advanced treatments, like radiation and chemotherapy, was often exacerbated by poor provider-provider communication issues. Ongoing Treatment: As treatment progressed, many veterans experienced a growing familiarity with their routine, and simultaneously, began to regain a sense of control. Care Team: Nurse navigators were considered vital to cancer care coordination. Veterans valued honesty and transparency from their providers which built a sense of trust.
Conclusion: Veterans expressed a need to have care coordination needs and steps more explicitly addressed early, as well as active mechanisms to meet those needs. The patient experience of coordination gradually improved over the course of the care trajectory, often facilitated by relationships fostered with members of the healthcare team.
