Post-treatment Support Research Articles

Posttreatment health interventions for adult cancer survivors and their families: an integrated review

PurposeThis review aimed to synthesize the literature regarding health interventions delivered to adult cancer survivors and their families during posttreatment phase.MethodsAn integrative literature review was conducted that included quantitative and qualitative studies. The search was carried out in four databases using the same terms or MeSH terms and included data from January 2012 to February 2024. After quality assessment, data were extracted and synthesized. The protocol was registered in PROSPERO.ResultsAmong the seven studies included, two studies were randomized controlled trials, three were observational, and two utilized a qualitative approach. The studies originated from France, Australia, Canada, the UK, and the USA. In total, 704 participants were included, 294 were cancer survivors, 40 were non-cancer patients, 271 were family and caregivers, and 99 were healthcare professionals. The studies assessed survival durations after cancer treatment, ranging from 18 months to 6 years. The sparse interventions found across the studies used a multifaceted approach tailored to address various aspects of cancer survivorship and caregiver support.ConclusionThis review provides insights into the complex landscape of posttreatment support requirements for cancer survivors and their family caregivers. This finding underscores the critical necessity for additional intervention research involving comprehensive, accessible, and supportive services that address the multifaceted dimensions of survivorship for the patient and family as a unit.

Aftercare for Survivors of Human Trafficking: A Case Study on Optimal Approach to Recovery and Integration

Human trafficking is a modern-day slavery that mostly disproportionate women in the society. This study aimed to fill the knowledge gaps regarding the aftercare experiences of human trafficking survivors as they navigated their recovery and reintegration into society, with a specific focus on the Philippines. The research investigated the effectiveness of aftercare interventions provided by agency, highlighting the importance of comprehensive and customized support systems. It drew on Empowerment Theory and Ecological Systems Theory to inform its analysis. The study utilized a qualitative intrinsic case study design, employing purposeful sampling to gather insights from social worker, psychologist, house parents, survivors and other professional involved in aftercare. Collecting data using typically involved conducting in-depth interviews, engaging with key informants, and facilitating focus group discussions. Emerging themes were analyzed using Braun and Clarke’s method of thematic analysis. The study uncovered two main themes: "Grappling with Adversities" and "Socio-emotional Transformation." It provided insight into the challenges and situations experienced by survivors, as well as the influence of support systems, healing processes, and personal development initiatives on their recovery. The research highlighted the significance of education, development of independent living skills, and provision of emotional support in empowering survivors. Suggested measures involved the establishment of thorough post-treatment support initiatives, public initiatives to raise awareness within the community, and ongoing professional training for workers. This study added to our knowledge of survivor empowerment within the realm of human trafficking and emphasized the importance of continued research and evaluation of aftercare programs.

Recovery from gaming addiction: A thematic synthesis

In recent years the field of gaming addiction has experienced an upsurge in empirical studies on various treatment approaches. Despite the advances in our understanding of how gaming addiction can be treated, the wider concept of recovery continues to be under-researched. The purpose of this review was to explore how individuals addicted to video games experience the process of recovery. Seven databases were systematically searched for qualitative studies. Eight studies representing the views of 225 participants were included in the review. Study findings were exported into NVivo software and analysed using Thematic Synthesis. Six themes were constructed: “developing awareness”, “deciding to change”, “the process of quitting”, “the challenges of quitting”, “recovery never stops” and “treatment for gaming addiction”. Except for the last, themes represent processes that most participants had gone through during recovery, though significant variation was found in how each process was experienced. In addition to overcoming addiction symptoms, recovery involved management of concomitant problems and various negative consequences of excessive gaming. Regarding practice implications, current findings suggest that treatment programs should adopt a multidimensional approach, providing evidence-based treatments, help for co-occurring problems, as well as pre- and post-treatment support to accommodate individuals at different stages of recovery. Further research is needed to expand our understanding of recovery, for instance, the impact of gender differences or how recovery experiences change based on different recovery goals (i.e., abstinence or reduced play time).

Evaluating the Usability of an mHealth App for Empowering Cancer Survivors With Disabilities: Heuristic Evaluation and Usability Testing.

More than 18 million cancer survivors are living in the United States. The effects of cancer and its treatments can have cognitive, psychological, physical, and social consequences that many survivors find incredibly disabling. Posttreatment support is often unavailable or underused, especially for survivors living with disabilities. This leaves them to deal with new obstacles and struggles on their own, oftentimes feeling lost during this transition. Mobile health (mHealth) interventions have been shown to effectively aid cancer survivors in dealing with many of the aftereffects of cancer and its treatments; these interventions hold immense potential for survivors living with disabilities. We developed a prototype for WeCanManage, an mHealth-delivered self-management intervention to empower cancer survivors living with disabilities through problem-solving, mindfulness, and self-advocacy training. Our study conducted a heuristic evaluation of the WeCanManage high-fidelity prototype and assessed its usability among cancer survivors with known disabilities. We evaluated the prototype using Nielsen's 10 principles of heuristic evaluation with 22 human-computer interaction university students. On the basis of the heuristic evaluation findings, we modified the prototype and conducted usability testing on 10 cancer survivors with a variety of known disabilities, examining effectiveness, efficiency, usability, and satisfaction, including a completion of the modified System Usability Scale (SUS). The findings from the heuristic evaluation were mostly favorable, highlighting the need for a help guide, addressing accessibility concerns, and enhancing the navigation experience. After usability testing, the average SUS score was 81, indicating a good-excellent design. The participants in the usability testing sample expressed positive reactions toward the app's design, educational content and videos, and the available means of connecting with others. They identified areas for improvement, such as improving accessibility, simplifying navigation within the community forums, and providing a more convenient method to access the help guide. Overall, usability testing showed positive results for the design of WeCanManage. The course content and features helped participants feel heard, understood, and less alone.

Not Two Sides of the Same Coin: A Qualitative Comparative Analysis of Post-Treatment Abstinence and Relapse.

Substance use disorder (SUD) can be a chronic relapsing condition with poor treatment outcomes. Studies exploring factors associated with abstinence or relapse after treatment are often quantitative in nature, applying linear statistical approaches, while abstinence and relapse result from non-linear, complex, dynamic and synergistic processes. This study aims to explore these underlying dynamics using qualitative comparative analysis (QCA) as a mixed methods approach to further our understanding of factors contributing to post-treatment abstinence and relapse. In a prospective study, we gathered both qualitative and quantitative data pertaining to post-treatment substance use and the factors linked to substance use outcomes. These factors encompassed psychiatric comorbidity, intellectual disability, social disintegration, post-treatment support, and engagement in activities among patients who had undergone inpatient treatment for severe SUD (n = 58). QCA, a set-theoretic approach that considers the complex interplay of multiple conditions, was applied to discern which factors were necessary or sufficient for the occurrence of either abstinence or relapse. We found two solutions predicting abstinence, and five for relapse. Post-treatment conditions (support and engagement in activities) were important for retaining abstinence. For relapse, individual baseline characteristics (intellectual disability, social disintegration, psychiatric comorbidity) combined with (post-)treatment factors (post-treatment support, activities) were important. Although abstinence and relapse represent opposing outcomes, they each exhibit distinct dynamics. To gain a comprehensive understanding of these dynamics, it is advisable to examine them as separate outcomes. For clinical practice, it can be worthwhile to recognize that fostering the conditions conducive to abstinence may differ from preventing the factors that trigger relapse.

Health-related quality of life, psychological issues and concerns among sarcoma survivors: a mixed method study.

We aimed to explore the health-related quality of life (HRQoL), psychological issues and concerns among sarcoma survivors in India and assess their satisfaction with nursing care. This study employed a sequential mixed-methods design, enrolling 100 sarcoma survivors from July to December 2021, with data collected using standardised questionnaires for HRQoL, depression, anxiety, stress, cognitive impairment and self-structured satisfaction with nursing care. Qualitative data were gathered through focused group discussions. The mean global health score among sarcoma survivors was 79.48 ± 16.26. A significant number of survivors had symptoms of mild-to-moderate depression (30%), severe anxiety (12%), stress (16%) and mild cognitive impairment (5%). Significant mean rank differences were observed between anxiety and financial difficulty (p < 0.05), emotional functioning (p < 0.001), cognitive functioning (p < 0.001), pain (<0.05), insomnia (p < 0.001), fatigue (p < 0.001), anorexia (p < 0.05) and nausea/vomiting (p < 0.001). Educational qualification had a significant association with depression and anxiety while family history of cancer emerged as a significant factor associated with anxiety and stress among survivors. Qualitative analysis revealed themes related to body image, societal discrimination, socio-economic impact, marriage concerns and fertility issues. Survivor satisfaction with nursing care was good. A substantial number of sarcoma survivors had an average HRQoL and experienced depression, anxiety and stress. Our study emphasizes the importance of holistic survivorship care, involving nurses in post-treatment support, and addressing societal discrimination and psychosocial concerns to enhance their quality of life. Our study calls for a holistic approach to sarcoma survivor care and emphasizes the importance of personalised survivorship care plans led by nurses to address the diverse needs of sarcoma survivors in India. Such plans should encompass strategies for managing depression, anxiety and stress, along with addressing body image concerns and social support.

Evaluation of a person-centred, nurse-led model of care delivering hepatitis C testing and treatment in priority settings: a mixed-methods evaluation of the Tasmanian Eliminate Hepatitis C Australia Outreach Project, 2020–2022

IntroductionAustralia has experienced sustained reductions in hepatitis C testing and treatment and may miss its 2030 elimination targets. Addressing gaps in community-based hepatitis C prescribing in priority settings that did not have, or did not prioritise, hepatitis C testing and treatment care pathways is critical.MethodsThe Tasmanian Eliminate Hepatitis C Australia Outreach Project delivered a nurse-led outreach model of care servicing hepatitis C priority populations in the community through the Tasmanian Statewide Sexual Health Service, supported by the Eliminating Hepatitis C Australia partnership. Settings included alcohol and other drug services, needle and syringe programs and mental health services. The project provided clients with clinical care across the hepatitis C cascade of care, including testing, treatment, and post-treatment support and hepatitis C education for staff.ResultsBetween July 2020 and July 2022, a total of 43 sites were visited by one Clinical Nurse Consultant. There was a total of 695 interactions with clients across 219 days of service delivery by the Clinical Nurse Consultant. A total of 383 clients were tested for hepatitis C (antibody, RNA, or both). A total of 75 clients were diagnosed with hepatitis C RNA, of which 95% (71/75) commenced treatment, 83% (62/75) completed treatment and 52% (39/75) received a negative hepatitis C RNA test at least 12 weeks after treatment completion.ConclusionsProviding outreach hepatitis C services in community-based services was effective in engaging people living with and at-risk of hepatitis C, in education, testing, and care. Nurse-led, person-centred care was critical to the success of the project. Our evaluation underscores the importance of employing a partnership approach when delivering hepatitis C models of care in community settings, and incorporating workforce education and capacity-building activities when working with non-specialist healthcare professionals.

Evaluating end of treatment care of young people with cancer.

Existing literature implies there may be gaps in post-treatment support for young people with cancer. This service evaluation explored the needs and experiences of young people when ending cancer treatment in a UK children's hospital to inform service provisions. Semi-structured interviews were conducted with nine young people, aged 13-18years, who had finished active cancer treatment and were receiving follow-up care. The data was analysed using thematic analysis. Four main themes were developed: being in the dark (i.e. limited awareness of what happens when treatment ends); separation from the hospital (i.e. the loss of valued support from staff); consequences of cancer (i.e. managing ongoing psychological and physical effects); and getting back to normal life (i.e. shifting from hospital to everyday life). Recommendations for improving clinical practice were made. Greater preparedness for ending treatment could be achieved by clearly setting out ongoing care arrangements, providing resource packs, having opportunities to mark the end of treatment, and offering peer support. To identify specific post-treatment needs, there should be an end of treatment multidisciplinary review and space for young people to share how they are feeling in follow-up medical appointments.

Factors that affect quality of life for older people with head and neck cancer: A systematic review.

Quality of life is a critical aspect in the management of older head and neck cancer patients. It needs to be considered alongside survival benefit, treatment burden, and longer-term outcomes. The purpose was to undertake a systematic review of empirical peer-reviewed studies with a primary focus on factors impacting quality of life for older head and neck cancer patients. A systematic review, searching 5 electronic databases (PsychoINFO, MEDLINE, CINHAL, Embase, and Scopus) using PRISMA methodology was conducted. Data was appraised using the Newcastle-Ottawa scale and a narrative synthesis performed. Only 10 papers fulfilled the inclusion criteria. Two main themes emerged: 1) Impact of head and neck cancer on quality of life domains and 2) quality of life in treatment decision-making. In an era of progressive personalised care, there is an evident need for more qualitative and quantitative studies focusing on quality of life for older head and neck cancer patients. However, older head and neck cancer patients experience notable differences, especially with poorer physical functioning and greater eating and drinking challenges. Quality of life impacts older patients decision-making, treatment planning and intensifies post-treatment support.

Patient-Reported Outcomes After Chemoradiation in Patients With Anal Cancer: A Qualitative Analysis

PurposePelvic chemoradiation therapy (CRT) is the curative therapy for non-metastatic anal cancer, resulting in excellent survival rates. However, anal cancer survivors may experience diminished quality of life (QOL) due to late toxicities from pelvic CRT. Few studies use patient-reported QOL, and few include thematic analyses of the patient experience in their own words. We conducted a survey study with qualitative analysis of free-text responses to explore themes of patient perceptions of their QOL during and after pelvic CRT to inform future interventions, reform patient education, and improve outcomes. Methods and MaterialsWe surveyed 248 patients with anal cancer treated with definitive intensity modulated radiation and concurrent chemotherapy from 2010 to 2018 who were alive and without recurrence. The survey included the Functional Assessment of Cancer Therapy General 7 item version, questions about satisfaction with preparation and patient education, and an optional free-text response question. Survey free response data were analyzed using the constant comparative method of qualitative analysis. Representative themes were generated. ResultsOne-hundred and twelve patients (45%) completed surveys. Of these respondents, 84 (75%) answered the free-text question. The median (interquartile range) Functional Assessment of Cancer Therapy General 7 item version score for survey responders (N = 112) was 21 (range, 15-24). Three themes most mentioned by respondents were persistent toxicity effecting QOL (82%), insufficient upfront information about CRT (56%), and gratitude toward care received (35%). ConclusionsPatients described late toxicities that affect QOL after pelvic CRT for anal cancer. This may be partially due to insufficient preparative information and post-treatment support. This study contributes to the literature supporting improved patient education and side effect management to augment long-term QOL for survivors of anal cancer.

Experiences of Healthcare Workers of Hospitalised Individuals with covid-19 in Kano, Nigeria: A Qualitative Study

Abstract Background: Management of patients with covid-19 needing hospitalisation is challenging worldwide. However, little or no information has been gathered regarding the experiences of healthcare workers (hcw s) involved in the care of patients with covid-19 in poorly resourced settings. This study explored the experiences of hcw s managing hospitalised patients with covid-19 in a treatment centre in Kano, Nigeria. Methods: hcw s directly or indirectly involved in managing patients with covid-19 in one of the two treatment centres in Kano, Nigeria, were sampled based on being information-rich cases. The study participants were interviewed individually via telephone using a semi-structured interview guide. Data collection was stopped when content saturation was attained. Data was analysed using thematic synthesis. Results: Eleven hcw s, comprising two medical doctors, five nurses, a laboratory staff member, a community health extension worker, an environmental health officer and a cleaner, participated in this study. Four major themes were generated: (i) the profile and readiness of hcw s prior to being engaged to work in a covid-19 treatment centre, (ii) the experience of hcw s while working in the covid-19 treatment wards, (iii) challenges with working in covid-19 treatment wards, and (iv) post-treatment support for covid-19 patients. The participants had variable prior experience in managing patients with infectious diseases. Interventions offered were mainly antiviral therapy, nursing care, counselling, nutritional interventions and toilet hygiene. Challenges encountered included insufficient cooperation from patients, poor personnel welfare, lack of human resources/equipment and issues interfering with wellbeing (stigma). Conclusion: The studied population exhibited professional competence and success in managing hospitalised patients with covid-19 during hospitalisation, despite existing challenges.

Improving Survivors' Quality of Life Post-Treatment: The Perspectives of Rural Australian Cancer Survivors and Their Carers.

Simple SummaryExisting programs to support cancer survivors post-treatment tend to be delivered face-to-face, reducing their accessibility to those living in rural and remote locations. Additionally, little is known about the acceptability of urban-developed survivorship care programs among rural cancer survivors who may have unique values and different attitudes towards help-seeking. The purpose of this study was to explore the experiences of cancer survivors who return to their rural communities upon completion of active treatment, and to identify the challenges these survivors experience in engaging with quality of life-related support services. The findings of this study will inform the design and development of new interventions, or modification of existing interventions, to better meet the preferences and needs of rural survivors. Identifying the specific challenges and intervention preferences of rural cancer survivors will help to ensure they benefit as much as urban survivors, from efforts to improve post-treatment quality of life.The transition from urban centres back to rural and remote communities can be challenging for rural cancer survivors after treatment. This study aimed to (a) provide deeper understanding of the experiences of rural survivors who have completed active cancer treatment and returned to their rural communities, and (b) determine strategies to re-orient existing services or develop new interventions to more appropriately meet rural survivors’ service preferences and needs. Semi-structured interviews were conducted with 22 adults (64% female) who lived outside of a metropolitan area and had completed active cancer treatment (n = 13), were the carer for a rural/remote cancer survivor (n = 6), or were both a survivor and carer (n = 3). Thematic analysis was conducted to identify dominant themes in the qualitative data. A range of physical, psychological and practical challenges that impact quality of life among rural survivors post-treatment were found. These challenges appeared to be compounded by a lack of trust in local rural healthcare services and a lack of clear post-treatment pathways to quality of life-enhancing support services. Acceptable strategies to overcome barriers included nurse-led, telephone-based, or face-to-face interventions, initiated and continued by the same service provider, and that included support to manage emotional challenges associated with post-treatment survivorship. The findings will inform the design of interventions to better meet rural cancer survivors’ post-treatment support needs.

Disability and post-trauma stress in the population over 15 years old in Kashan, Iran: A population-based study

PurposeOne of the consequences of trauma-related injuries is disability. There are more than one billion people with disabilities worldwide. Disability in people reduces their quality of life. The goal of this study was to determine the rate of post-trauma stress and disability related to trauma in the population over 15 years old in Kashan during a solar year of 2018–2019. MethodsThis is a cross-sectional population-based study. A cluster sampling method was used in the city of Kashan, and 3880 persons were interviewed with individuals randomly selected in each household. If a person had trauma during one year ago, the World Health Organization Disability Assessment Schedule 2.0 and Post Trauma Stress Disorder (PTSD) Checklist were applied for further interview. Data were analyzed using Chi-square test or t-test. ResultsAmong the 3880 participants residing in Kashan, 274 (7.1%) reported a history of traumatic injury during one year ago in 2018–2019. Incidence of all injuries was estimated to be 70.61 (62.60–78.70) per 1000 people. For the trauma population, 213 (77.7%) were male and 75.1% were married. About half of them (50.3%, 138/274) aged 21–39 years. The most common cause of injuries was related to traffic accidents: 140 (51.1%). Of the 274 trauma participants, 47 (17.2%) reported PTSD; 244 (89.1%) had a mild disability, and 30 (10.9%) reported moderate disability. ConclusionOne of the main causes of disability in the human community is the traumatic injuries. According to the results of this study, 89.1% of trauma participants have sustained at last mild disability following trauma. These people require follow-up and post-treatment support. It should be noted that psychological complications such as PTSD are as significant as physical symptoms.

Self-identity, lived experiences, and challenges of breast, cervical, and prostate cancer survivorship in Mexico: a qualitative study

BackgroundQualitative research on cancer patients’ survivor-identity and lived experiences in low- and middle-income countries is scarce. Our study aimed at exploring the concept and experience of survivorship for Mexicans living with breast, cervical, and prostate cancer.MethodsWe conducted a qualitative study in Mexico City, Morelos, Nuevo León, and Puebla. The participants were breast, cervical, and prostate cancer patients ≥18 years of age with completed primary cancer treatment. Data were collected via in-depth interviews and analyzed using an inductive thematic approach.ResultsThe study included 22 participants with a history of breast, 20 cervical, and 18 prostate cancer. Participants accepted the term “cancer survivor” as a literal interpretation of being alive, medical confirmation of treatment completion, or achievement of a clinical result possibly indicative of cure. The majority of respondents perceived that the future is out of their control and under God’s will. They linked cure to divine intervention and did not demonstrate the sense of empowerment that is often associated with the survivorship term. The principal themes of their narratives encompass: 1) adverse physical and sexual experiences; 2) emotional problems; 3) cancer-related stigma; 4) challenges to obtaining health-related information; 5) financial hardship; and 6) experience of strengthening family ties in order to provide them with support. In addition, women with breast cancer reported distress caused by changes in body image and positive experience with support groups.ConclusionIn Mexico, cancer patients report complex survivorship experiences that demand post-treatment follow-up and support. There is the need to implement comprehensive, culturally-relevant survivorship programs focused on emotional, informational, and in-kind support and empowerment of cancer patients.

Living life post cancer treatment (LLPCT): An assessment of a 12-week multidimensional wellness intervention to improve quality of life and physical activity in cancer survivors.

12052 Background: Cancer survivors face unique health challenges with implications on health-related quality of life (HRQoL) and physical, social, and emotional wellbeing. With advancements in cancer treatment and aging populations, the prevalence of cancer survivors is expected to grow prompting the need for improved survivorship care delivery and comprehensive rehabilitative services. Living Life Post Cancer Treatment (LLPCT) is a community-based 12-week program that provides multidimensional support to patients of any cancer diagnosis transitioning from active treatment to post-treatment life. This single-arm intervention study aims to assess the program’s impact on HRQoL and physical activity in cancer survivors. Methods: A total of 125 participants within 2 years of treatment completion were enrolled in a 12-week program comprised of 9 sessions of engaging workshops, personalized exercise training, and nutrition and psychosocial counseling with an interprofessional team of oncology providers, social workers, exercise trainers, and dietitians. The program consisted of 8 consecutive weekly sessions followed by a 1-month follow-up session at week 12. Ninety-six (77%) participants completed the eighth or ninth session of the program and were included in the analysis. A series of questionnaires were administered at baseline and weeks 8 and 12. Primary outcomes assessed were HRQoL using the Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire and physical activity using average daily steps by pedometer and 2-minute step test performance. Results: Among the 96 participants (mean age 60.4 ± 11.7) who completed the program, the majority were female, white, and married. Post-intervention median FACT-G scores significantly increased from baseline at weeks 8 (+8.8, p = 0.002) and 12 (+7.3, p &lt; 0.001). Average daily steps by pedometer increased by 1063 (p = 0.003) and 1233 (p = 0.015) and 2-minute step test performance increased by 18 (p &lt; 0.001) and 21 (p &lt; 0.001) steps at weeks 8 and 12, respectively. Participants reported high levels of satisfaction and improved self-efficacy to incorporate lifestyle modifications. Conclusions: These findings suggest that this 12-week intervention improves HRQoL and step-based physical activity levels in cancer survivors and could serve as a multidimensional model for post-treatment support. Further research is needed to determine if these benefits are sustained long-term.

Critical components of interventions to promote resilience among children with maltreatment experiences: A qualitative study of practitioners’ perspectives

Although researchers and practitioners keep working on identifying efficacious interventions for children with maltreatment experiences, few studies explore the perspective of the clinicians for their perspective of the critical components of interventions to promote resilience among maltreated children. To address this research gap, 27 interviews were conducted with clinicians to examine the critical components that should be incorporated into interventions. Four primary themes were captured from practitioners’ perspective: (1) therapist characteristics; (2) caregiver characteristics; (3) community influences; and, (4) post-treatment support. Findings of this study benefit the improvement of future clinical interventions to promote the resilience of maltreated children.

Improving access to post-treatment support for patients with cancer – thinking outside the box: A patient perspective

Introduction:Aggressive cancers such as mantle cell lymphoma are life-changing diseases, affecting all aspects in the life of a patient. Not only affecting a patient physically due to the disease i...

Characteristics and Significance of Professional-Led Support Groups in the Treatment of Alcoholism

ABSTRACTA distinctive form of posttreatment support for persons in recovery from alcoholism (alcohol use disorders) is the club of treated alcoholics (CTA). These groups are in the tradition of Alcoholics Anonymous with several important distinctions: the CTA groups are led by a health or social care professional, family members are included in the group, and groups are encouraged to be active in local community. This is a descriptive study of 40 randomly selected CTA groups with a focus on how participation in these groups improves the level of psychosocial functioning in the participants with a focus on how the participants relate to each other and the assigned health care professional.

A qualitative study of the post-treatment experiences and support needs of survivors of lymphoma.

To explore the post-treatment experiences and preferences for follow-up support of lymphoma survivors. Two focus groups were conducted with 17 participants to explore informational, psychological, emotional, social, practical and physical needs, 6-30 months post-treatment for lymphoma. Perceptions regarding a potential model of survivorship care were also elicited. Thematic content analysis revealed five key themes: Information; Loss and uncertainty; Family, support and post-treatment experience; Transition, connectivity and normalcy, and Person-centred post-treatment care. Participants described a sense of loss as they transitioned away from regular interaction with the hospital at the end of treatment, but also talked about the need to find a "new normal". Establishing post-treatment support structures that can provide individualised information, support, reassurance and referrals to community and peer support were identified as a helpful way to navigate the transition from patient to post-treatment survivor. Participants in our study articulated a need for a flexible approach to survivorship care, providing opportunities for individuals to access different types of support at different times post-treatment. Specialist post-treatment nurse care coordinators working across acute and community settings may offer one effective model of post-treatment support for survivors of haematological malignancies.

The Perceptions and Expectations of Older Women in the Establishment of the Senior Women's Breast Cancer Clinic (SWBCC): a Needs Assessment Study.

This study explored older women's perceptions and expectations of the prospective Senior Women's Breast Cancer Clinic (SWBCC) at Sunnybrook Odette Cancer Centre (SOCC) in Toronto, Ontario, Canada. In our previous studies, older breast cancer patients had expressed a greater need for informational, decisional, and post-treatment support. This study also assessed women's perspectives on the involvement of geriatricians and incorporation of geriatric assessment in their cancer care. Twelve breast cancer patients aged 68years or older who were treated at the SOCC participated in the study. We recorded and transcribed 11 interviews and analyzed them using qualitative thematic analysis methods to identify major themes; one interview was excluded due to recording defect. Eight major themes were identified: transportation issues, service, communication between patient and healthcare professionals, communication between healthcare professionals, support during treatment, support after treatment, informational resources, and patient suggestions. Important issues were raised by participants, such as difficulties in arranging transportation to the clinic, barriers in accessing family physician service, and communication breakdown that result in treatment delay and unaddressed complications. In conclusion, there were important gaps in the cancer care of older women with breast cancer that could be detected earlier and better addressed in the new multidisciplinary SWBCC. The participating women were highly supportive of the initiative and made several suggestions on how the clinic could better accommodate their specific needs during and after breast cancer treatment.