Virtual nurse-led care models designed with health care professionals (HCPs) and patients may support addressing unmet prostate cancer (PCa) survivor needs. Within this context, we aimed to better understand the optimal design of a service model for a proposed nurse-led PCa follow-up care platform (Ned Nurse).
A qualitative descriptive study exploring follow-up and virtual care experiences to inform a nurse-led virtual clinic (Ned Nurse) with an a priori convenience sample of 10 HCPs and 10 patients. We provide a health ecosystem readiness checklist mapping facilitators onto CFIR and Proctor's implementation outcomes.
We show that barriers within the current standard of care include: fragmented follow-up, patient uncertainty, and long, persisting wait times despite telemedicine modalities. Participants indicate that a nurse-led clinic should be scoped to coordinate care and support patient self-management, with digital literacy considerations.
A nurse-led follow-up care model for PCa is seen by HCPs as acceptable, feasible, and appropriate for care delivery. Patients value its potential to provide role clarity, reinforce continuity of care, enhance mental health support, and increase access to timely and targeted care. These findings inform design, development, and implementation strategies for digital health interventions within complex settings, revealing opportunities to optimally situate these interventions to improve care.
Prostate cancer (PCa) survivors in Canada receive follow-up care after treatment through a specialist-led model, which is currently straining to meet patient needs. We interviewed healthcare providers (HCPs) and patients to investigate the design and development of a healthcare service that uses technology, also known as virtual care, to provide nurse-led follow-up care. Mixed experiences with virtual care informed participant feedback and concerns, including impacts of the pandemic and digital literacy considerations. We show that HCPs and patients see potential benefit in virtual nurse-led follow-up care if it can increase access to resources, clarify patient and provider care roles, and improve access and continuity of care. This type of approach to follow-up care may help to improve survivor quality of life and PCa follow-up care while extending the reach of healthcare systems with limited resources.
Communications medicine. 2023 Nov 02*** epublish ***
Karen Young, Ting Xiong, Kaylen J Pfisterer, Denise Ng, Tina Jiao, Raima Lohani, Caitlin Nunn, Denise Bryant-Lukosius, Ricardo Rendon, Alejandro Berlin, Jacqueline Bender, Ian Brown, Andrew Feifer, Geoffrey Gotto, Joseph A Cafazzo, Quynh Pham
Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada., Centre for Digital Therapeutics, University Health Network, Toronto, ON, Canada., School of Nursing, McMaster University, Hamilton, ON, Canada., Department of Urology, Queen Elizabeth II Health Sciences Centre, Halifax, ON, Canada., Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada., Division of Urology, Niagara Health System, Saint Catharines, ON, Canada., Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada., Division of Urology, University of Calgary, Calgary, AB, Canada., Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada. .