Facilitators of Survivorship Care Among Underserved Breast Cancer Survivors: a Qualitative Study

Abstract

Purpose Research investigating facilitators of survivorship care among underserved breast cancer survivors (BCS) is sparse. This study aimed to explore facilitators of survivorship care among underserved BCS within the first five years following chemotherapy, radiation, or surgery for breast cancer. Methods In-depth interviews were conducted, using a semi-structured interview guide, with underserved BCS exploring survivorship care experiences. Content analysis of the verbatim transcripts was applied, and results were summarized according to themes related to facilitators of breast cancer survivorship care. Results Interviews were conducted with 25 BCS. Eight main themes were identified: Coordination of care; positive perceptions of health care providers; communication between patient and health care providers; financial and insurance facilitators; information, classes, and programs provided; assistance provided by organizations and health care professionals; transportation facilitators; and job flexibility. Conclusions This study provides a comprehensive look at facilitators of survivorship care among underserved BCS. BCS endorsed several facilitators of their survivorship care, mainly at the interpersonal, organizational, and societal level. Implications for Cancer Survivors This study adds to the research literature on catalysts of care among underserved BCS. Results from this study are currently being used to inform a patient navigation intervention to facilitate care among this population.

“I Will Not Be Defined by This. I’m Not Going to Live Like a Victim; It Is Not Going to Define My Life”: Exploring Breast Cancer Survivors’ Experiences and Sense of Self

“…This study’s findings may help health care professionals provide care for women with BC in that it highlights the process of identity reconstruction that some women undergo in the survivor journey and how this may impact on psychosocial well-being (Emslie et al, 2017; Reynolds et al, 2020). The telling of our survivor’s experiences also contributes to further knowledge in embodying care physically, emotionally, and mentally for patients and survivors’ support networks; to reduce distress and fear; and to facilitate a higher rate of survivorship (Ustjanauskas et al, 2017).…”

“…A diagnosis of cancer is a life-changing, disturbing, and identity-altering event (Park et al, 2009). Identity transformation or negotiation is likely to occur at every stage of a patient’s life, including initial assessment to biopsy: treatment to post-treatment (Davis, 2008; Ustjanauskas et al, 2017). Some cancer survivors are inclined to restore their previous identity by upholding their preexisting values and belief systems, personal habits, and their persona in society.…”

“…Psychological ownership refers to sense of self and the perception of control over the distressful cancer diagnosis (Karnilowicz, 2011). Psychological ownership is vital to some as cancer patients recognize their desire to maintain good health, their pervasive fear of the uncertainty about the future, and their relationship and support from family and health care providers (Ustjanauskas et al, 2017). This identity shift becomes a catalyst to survivorship.…”

“…Women with BC under these circumstances are often confronted by a process of “identity destruction” followed by a period of transformation expressed within an “identity reconstruction” (Davis, 2008; Piot-Ziegler et al, 2010; Reynolds et al, 2020). Identity destruction starts at the point of diagnosis with feelings of loss, isolation, dissociation, and alienation (Ustjanauskas et al, 2017), and the questioning of the foundation of one’s self-identity (Sandole & Auerbach, 2013). The reconstructed self comes as a response to the known self being challenged and questioned (Park et al, 2009).…”

Addressing a critical need for caregiver support in neuro-oncology: development of a caregiver navigation intervention using eSNAP social resource visualization

“…The program and associated training were based on the design of three previous patient navigation programs: the Moffitt Cancer Center Patient Navigator Research Program patient navigation intervention, [ 26 , 27 ] a breast cancer survivorship navigation intervention, [ 28 ] and the PrEPárate HIV prevention patient navigation intervention [ 29 ]. All of these programs were developed with extensive involvement from patients to assist diverse and lower-resourced individuals to obtain high quality, recommended health care in a timely manner [ 28 , 30 ]. Members of the study team reviewed existing program materials, including patient-facing materials and training manuals, and adapted elements of these programs based on the stress process conceptual model (Fig.…”