Implementing a community-based shared care breast cancer survivorship model in Singapore: a qualitative study among primary care practitioners

被引：5

作者：

Ke, Yu ^{[1
]}

Fok, Rose Wai Yee ^{[2
]}

Soong, Yoke Lim ^{[3
]}

Loh, Kiley Wei-Jen ^{[2
]}

Farid, Mohamad ^{[2
]}

Low, Lian Leng ^{[4
]}

Quah, Joanne Hui Min ^{[5
]}

Vasanwala, Farhad Fakhrudin ^{[6
]}

Low, Sher Guan ^{[7
]}

Soh, Ling Ling ^{[7
]}

Tan, Ngiap-Chuan ^{[5
]}

Chan, Alexandre ^{[8
,9
]}

机构：

[1] Natl Univ Singapore, Dept Pharm, Singapore, Singapore

[2] Natl Canc Ctr Singapore, Div Med Oncol, Singapore, Singapore

[3] Natl Canc Ctr Singapore, Dept Radiat Oncol, Singapore, Singapore

[4] Duke NUS Med Sch Singapore, Singapore Gen Hosp Singapore Family Med & Continu, Singapore, Singapore

[5] Duke NUS Med Sch Singapore, SingHlth Polyclin Singapore, Singapore, Singapore

[6] Inst Mental Hlth, Singapore, Singapore

[7] Sengkang Community Hosp Singapore, Postacute & Continuing Care, Singapore, Singapore

[8] Natl Canc Ctr Singapore, Dept Pharm, Singapore, Singapore

[9] Univ Calif Irvine, Sch Pharm & Pharmaceut Sci, Dept Clin Pharm Practice, 101 Theory,Suite 100,Mail Code 3958, Irvine, CA 92697 USA

来源：

BMC PRIMARY CARE | 2022年 / 23卷 / 01期

关键词：

Cancer survivor; Breast cancer; Primary care; Continuity of care; Delivery of health care; FOLLOW-UP CARE; DECISION-MAKING; NEEDS; INTERVENTIONS; PERSPECTIVES; PROVIDERS; DIFFUSION; FRAMEWORK; BARRIERS;

D O I：

10.1186/s12875-022-01673-3

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Background The adaptability of existing recommendations on shared care implementation to Asian settings is unknown. This qualitative study aims to elicit public- and private-sectors primary care practitioners' (PCPs) perspectives on the sustainable implementation of a shared care model among breast cancer survivors in Singapore. Methods Purposive sampling was employed to engage 70 PCPs from SingHealth Polyclinics, National University Polyclinics, National Healthcare Group Polyclinics, and private practice. Eleven focus groups and six in-depth interviews were conducted between June to November 2018. All sessions were audio-recorded and transcribed verbatim. Guided by the RE-AIM framework, we performed deductive thematic analysis in QSR NVivo 12. Results PCPs identified low-risk breast cancer survivors who demonstrated clear acceptability of PCPs' involvement in follow-up as suitable candidates for shared care. Engagement with institution stakeholders as early adopters is crucial with adequate support through PCP training, return pathways to oncologists, and survivorship care plans as communication tools. Implementation considerations differed across practices. Selection of participating PCPs could consider seniority and interest for public and private practice, respectively. Proposed adoption incentives included increased renumeration for private PCPs and work recognition for public PCPs. Public PCPs further proposed integrating shared care elements to their existing family medicine clinics. Conclusions PCPs perceived shared care favorably as it echoed principles of primary care to provide holistic and well-coordinated care. Contextual factors should be considered when adapting implementation recommendations to Asian settings like Singapore. With limited competitive pressure, the government is then pivotal in empowering primary care participation in survivorship shared care delivery.

引用

页数：10

共 55 条

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