Experiences of health professionals treating women diagnosed with cancer during pregnancy and proposals for service improvement

Objective: To examine the experiences, needs, and perceptions of health professionals(HPs) treating women diagnosed with cancer during pregnancy(gestational cancer, GC). Methods: Interviews were undertaken with Australian HPs who had treated women diagnosed with GC over the previous five years. HPs...

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Main Authors: Lesley Stafford, Michelle Sinclair, Katrin Gerber, Christobel Saunders, Angela Ives, Michelle Peate, Jocelyn Lippey, Mark P. Umstad, Ruth Little
Format: Article
Language:English
Published: Elsevier 2022-06-01
Series:Breast
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S0960977622000534
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author Lesley Stafford
Michelle Sinclair
Katrin Gerber
Christobel Saunders
Angela Ives
Michelle Peate
Jocelyn Lippey
Mark P. Umstad
Ruth Little
author_facet Lesley Stafford
Michelle Sinclair
Katrin Gerber
Christobel Saunders
Angela Ives
Michelle Peate
Jocelyn Lippey
Mark P. Umstad
Ruth Little
author_sort Lesley Stafford
collection DOAJ
description Objective: To examine the experiences, needs, and perceptions of health professionals(HPs) treating women diagnosed with cancer during pregnancy(gestational cancer, GC). Methods: Interviews were undertaken with Australian HPs who had treated women diagnosed with GC over the previous five years. HPs were recruited via social media, and professional and community networks. Questions focussed upon HPs’ confidence caring for these women, whether current guidelines/training met their needs, psychological impacts of care provision, and service gaps. Interview data were analysed thematically. Results: Twenty-seven HPs were interviewed; most were oncology HPs(22/27) with experience caring for women with gestational breast cancer and 13 had a breast-specific clinical focus (e.g. breast surgeon). Many were currently treating women with GC(48%) or had in the last 6–12 months(29.6%). Four themes were identified: A clinically complex case, Managing multi-disciplinary care, Centralised resources for health professionals, and Liaison, information and shared experiences for women. HPs found this population personally challenging to treat. They reported initial uncertainty regarding treatment due to infrequent exposure to GC, limited resources/information, and the need to collaborate with services with which they did not usually engage. Solutions offered include centralised resources, clinical liaison/care coordinators, and connecting women with GC with peer support. Conclusions: HPs perceived women with GC as a vulnerable, complex population and experienced challenges providing comprehensive care; particularly when treatment was delivered at geographically separated hospitals. Systemic changes are needed to optimise comprehensive care for these women. Their insights can guide the development of more integrated cancer and obstetric care, and better HP support.
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spelling doaj.art-feeb8e081517466f8f7836b2fbe1e9c62022-12-22T02:08:54ZengElsevierBreast1532-30802022-06-01637176Experiences of health professionals treating women diagnosed with cancer during pregnancy and proposals for service improvementLesley Stafford0Michelle Sinclair1Katrin Gerber2 Christobel Saunders3Angela Ives4Michelle Peate5Jocelyn Lippey6Mark P. Umstad7Ruth Little8Women's Mental Health Service. Royal Women's Hospital, Parkville 3052, VIC, Australia; Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, 3010, Australia; Corresponding author. Women's Mental Health Service, The Royal Women's Hospital Locked Bag 300 Parkville 3052 Australia.Women's Mental Health Service. Royal Women's Hospital, Parkville 3052, VIC, AustraliaMelbourne Ageing Research Collaboration, National Ageing Research Institute, Royal Melbourne Hospital, 3050, VIC, Australia; Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, 3010, AustraliaMedical School, The University of Western Australia, 6009, WA, Australia; Fiona Stanley and St John of God Subiaco Hospitals, Subiaco, 6008, WA, AustraliaMedical School, The University of Western Australia, 6009, WA, AustraliaDepartment of Obstetrics and Gynaecology, University of Melbourne, Parkville, 3010, VIC, AustraliaDepartment of Surgery, University of Melbourne, Parkville, 3010, VIC, Australia; Department of Surgery, St. Vincent's Hospital, Fitzroy, 3065, VIC, Australia; Department of Surgery, The Northern Hospital, Epping, 3076, VIC, AustraliaDepartment of Maternal-Fetal Medicine, The Royal Women's Hospital, Parkville, 3052, VIC, Australia; Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, 3010, VIC, AustraliaWomen's Mental Health Service. Royal Women's Hospital, Parkville 3052, VIC, AustraliaObjective: To examine the experiences, needs, and perceptions of health professionals(HPs) treating women diagnosed with cancer during pregnancy(gestational cancer, GC). Methods: Interviews were undertaken with Australian HPs who had treated women diagnosed with GC over the previous five years. HPs were recruited via social media, and professional and community networks. Questions focussed upon HPs’ confidence caring for these women, whether current guidelines/training met their needs, psychological impacts of care provision, and service gaps. Interview data were analysed thematically. Results: Twenty-seven HPs were interviewed; most were oncology HPs(22/27) with experience caring for women with gestational breast cancer and 13 had a breast-specific clinical focus (e.g. breast surgeon). Many were currently treating women with GC(48%) or had in the last 6–12 months(29.6%). Four themes were identified: A clinically complex case, Managing multi-disciplinary care, Centralised resources for health professionals, and Liaison, information and shared experiences for women. HPs found this population personally challenging to treat. They reported initial uncertainty regarding treatment due to infrequent exposure to GC, limited resources/information, and the need to collaborate with services with which they did not usually engage. Solutions offered include centralised resources, clinical liaison/care coordinators, and connecting women with GC with peer support. Conclusions: HPs perceived women with GC as a vulnerable, complex population and experienced challenges providing comprehensive care; particularly when treatment was delivered at geographically separated hospitals. Systemic changes are needed to optimise comprehensive care for these women. Their insights can guide the development of more integrated cancer and obstetric care, and better HP support.http://www.sciencedirect.com/science/article/pii/S0960977622000534CancerDelivery of healthcareGestationalHealth personnelPregnancyPsycho-oncology
spellingShingle Lesley Stafford
Michelle Sinclair
Katrin Gerber
Christobel Saunders
Angela Ives
Michelle Peate
Jocelyn Lippey
Mark P. Umstad
Ruth Little
Experiences of health professionals treating women diagnosed with cancer during pregnancy and proposals for service improvement
Breast
Cancer
Delivery of healthcare
Gestational
Health personnel
Pregnancy
Psycho-oncology
title Experiences of health professionals treating women diagnosed with cancer during pregnancy and proposals for service improvement
title_full Experiences of health professionals treating women diagnosed with cancer during pregnancy and proposals for service improvement
title_fullStr Experiences of health professionals treating women diagnosed with cancer during pregnancy and proposals for service improvement
title_full_unstemmed Experiences of health professionals treating women diagnosed with cancer during pregnancy and proposals for service improvement
title_short Experiences of health professionals treating women diagnosed with cancer during pregnancy and proposals for service improvement
title_sort experiences of health professionals treating women diagnosed with cancer during pregnancy and proposals for service improvement
topic Cancer
Delivery of healthcare
Gestational
Health personnel
Pregnancy
Psycho-oncology
url http://www.sciencedirect.com/science/article/pii/S0960977622000534
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