Factors that influence presentation to an emergency department during systemic anti-cancer therapy: An exploratory qualitative study

Abstract

PurposeTo explore factors that influence presentation to an emergency department during ambulatory systemic anti-cancer therapy. DesignAn exploratory qualitative study using semi-structured interviews. MethodsA purposive sample of adult patients with any cancer who had commenced systemic anti-cancer therapy in the ambulatory setting up to six months prior participated in semi-structured interviews between November 2016 – December 2017. Interviews were transcribed verbatim, and data analysed thematically using a template analysis approach. ResultsTwenty patients and four caregivers took part. Five themes were generated from the interview data: 1) the unknown and unpredictable; 2) a change of lifestyle; 3) social determinants and access; 4) trust in care providers; and 5) the unavailability of care. ConclusionAs the number of systemic anti-cancer agents and patients eligible for them continues to grow, identifying, implementing and evaluating initiatives to mitigate emergency department presentations present an important area for health services research. Addressing timely access to trusted care and enhancing patient capacity for self-management present important areas for nurse-led system innovation. Findings from this study offer important insights into where and how nurses can mitigate emergency department presentations for individuals receiving systemic anti-cancer therapy by enabling accessible, coordinated and person-centred cancer care.