B45
A prospective, longitudinal study to investigate the impact of changes in service provision for the follow-up of women (over 50 years) with primary breast cancer
Pauline Hyman-Taylor, John Robertson, Karen Cox
University of Nottingham, UK
Background
Improvements in surgical techniques/treatments created an increase in the rates and duration of survival. Exponential increase in the incidence of breast cancer is expected by 2030 National cancer guidelines stipulate psychological as well as physical follow up care. Follow-up clinic visits have been replaced with an open appointment system and 3 yearly mammograms.
Aim
To investigate the value and function of long term follow up care from the womens perspective, views on discharge from outpatient follow-up care, the influence of coping strategy, social support, quality of life, anxiety and depression on womens reactions.
Method
100 patients surveyed by questionnaire at discharge from clinic, 12 and 24 months later. Questionnaires: COPE Inventory, Significant Others Scale, EORTC QLQ-C30, EORTC BR23, HAD Scale. 20/100 patients gave qualitative in-depth interviews. Analysis: summary statistics using SPSS and grounded theory to generate themes via NVIVO.
Results (Interim)
Perceived value of follow-up care differs from the aims of the clinicians. Discharge from outpatient visits can be psychologically detrimental. Womens needs are not met by the open appointment system. Experience of others with cancer and the coping strategies adopted, influences risk beliefs. Fear of recurrent disease is the primary influential factor in womens reactions.
Conclusion
Demonstrated need for long term psychological care of breast cancer survivors. Unmet need has created a gap in service provision. Forward planning of resources is necessary and alternative strategies should be considered. Self-management techniques such as cognitive behavioural and mindfulness therapy are proven to be useful in long term cancer survivors as a useful alternative to outpatient clinic visits.
