Cancer, Fatigue
Conditions
Keywords
Oncology Service Hospital, Patient-centred, Exercise, Neoplasms, Rehabilitation, Qualitative Research, Health Plan Implementation, Quality of Health Care, Guidelines, Quality of Life
Brief summary
The aim of this study is to develop and identify the most effective strategy to implement PCRPs into daily care. We want to assess the added value of a multi-faceted strategy compared with a single-faceted patient-directed strategy.
Detailed description
The aim of this study is to develop and identify the most effective strategy to implement PCRPs into daily care. We want to assess the added value of a multi-faceted strategy compared with a single-faceted patient-directed strategy. We will conduct a clustered controlled before and after study (CBA) in the Netherlands that compares two strategies to implement PCRPs. The patient-directed (PD) strategy (five hospitals) will focus on change at the patient level. The multi-faceted (MF) strategy (five hospitals) will focus on change at the patient, professional and organizational levels. Eligibility criteria are as follows: (A) patients: adults; preferably (history of) cancer in the gastro-intestinal, reproductive and/or urological system; successful primary treatment; and without recurrence/metastases. (B) Healthcare professionals: involved in cancer care. A stepwise approach will be followed: Step 1: Analysis of the current implementation of PCRPs and the examination of barriers and facilitators for implementation, via a qualitative study with patients (four focus groups n = 10-12) and their healthcare workers (four focus groups n = 10-12 and individual interviews n = 30-40) and collecting data on adherence to quality indicators (n = 500 patients, 50 per hospital). Step 2: Selection and development of interventions to create a PD and MF strategy during expert's roundtable discussions, using the knowledge gained in step 1 and a literature search of the effect of strategies for implementing PCRPs. Step 3: Test and compare both strategies with a clustered CBA (effectiveness, process evaluation and costs), by data extraction from existing registration systems, questionnaires and interviews. For the effectiveness and cost-effectiveness, n = 500 patients, 50 per hospital. For the process evaluation, n=50 patients, 5 per hospital, and n = 40 healthcare professionals, 4 per hospital.
Interventions
OTHERThe patient-directed (PD) strategy
The patient-directed strategy will be designed to embed the success of implementation of PCRPs by influencing the patients.
OTHERThe multi-faceted (MF) strategy
The multi-faceted strategy will be designed to embed the success by not only influencing the patients, but also professionals and organizational aspects.
Sponsors
Radboud University Medical Center
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
patients: * preferably (history of) cancer in the gastro-intestinal, reproductive and/or urological system; successful primary treatment; and without recurrence/metastases. * Adults * Diagnosed in one of the participating hospitals * Able to read and understand Dutch Healthcare professionals: • involved in cancer care in one of the participating hospitals
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The percentage of screened patients with the screening tool recommended by the Dutch guideline 'Cancer Rehabilitation'. | baseline and at follow-up | A pre- and post measurement of 'the percentage of screened patients with the screening tool recommended by the Dutch guideline 'Cancer Rehabilitation'' will be done. The differences between the pre- and post measurement will be measured. |
| The percentage of referrals to PCRPs where needed, according to the Dutch guideline 'Cancer Rehabilitation'. | baseline and at follow-up | A pre- and post measurement of 'The percentage of referrals to PCRPs where needed, according to the Dutch guideline 'Cancer Rehabilitation'' will be done. The differences between the pre- and post measurement will be measured. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Remaining quality indicators of the Dutch guideline 'Cancer Rehabilitation'. | baseline and at follow-up | A pre- and post measurement of ' the Remaining quality indicators of the Dutch guideline 'Cancer Rehabilitation'' will be done. The differences between the pre- and post measurement will be measured. |
| Patientempowerment | baseline and at follow-up | A pre- and post measurement of 'patientempowerment' will be done. The differences between the pre- and post measurement will be measured. |
| Quality of life | baseline and at follow-up | A pre- and post measurement of 'QoL' will be done. The differences between the pre- and post measurement will be measured. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Process-evaluation | at follow-up | The experiences and exposure of patients and professionals with the PD- and MF strategy will be evaluated by interviews. |
| Cost | at follow-up | incremental costs and incremental cost-effectiveness ratios (ICERs) |
Countries
Netherlands
Contacts
Primary ContactC. IJsbrandy, MD
Backup ContactR.P.M.G. Hermens, PhD
Outcome results
None listed