Journal article
Optimizing virtual follow-up care: realist evaluation of experiences and perspectives of patients with breast and prostate cancer
- Abstract:
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Background:
Virtual follow-up (VFU) has the potential to enhance cancer survivorship care. However, a greater understanding is needed of how VFU can be optimized.Objective:
This study aims to examine how, for whom, and in what contexts VFU works for cancer survivorship care.Methods:
We conducted a realist evaluation of VFU among patients with breast cancer and prostate cancer at an urban cancer center during the COVID-19 pandemic. Realist evaluations examine how underlying causal processes of an intervention (mechanisms) in specific circumstances (contexts) interact to produce results (outcomes). Semistructured interviews were conducted with a purposive sample of patients ≤5 years after diagnosis. Interviews were audio-recorded and analyzed using a realist logic of analysis.Results:
Participants (N=24; n=12, 50% with breast cancer and n=12, 50% with prostate cancer) had an average age of 59.6 (SD 10.7) years. Most participants (20/24, 83%) were satisfied with VFU and wanted VFU options to continue after the COVID-19 pandemic. However, VFU impacted patient perceptions of the quality of their care, particularly in terms of its effectiveness and patient centeredness. Whether VFU worked well for patients depended on patient factors (eg, needs, psychosocial well-being, and technological competence), care provider factors (eg, socioemotional behaviors and technological competence), and virtual care system factors (eg, modality, functionality, usability, virtual process of care, and communication workflows). Key mechanisms that interacted with contexts to produce positive outcomes (eg, satisfaction) were visual cues, effective and empathetic communication, and a trusting relationship with their provider.Conclusions:
Patients value VFU; however, VFU is not working as well as it could for patients. To optimize VFU, it is critical to consider contexts and mechanisms that impact patient perceptions of the patient centeredness and effectiveness of their care. Offering patients the choice of in-person, telephone, or video visits when possible, coupled with streamlined access to in-person care when required, is important. Prioritizing and addressing patient needs; enhancing physician virtual socioemotional behaviors and technology competency; and enhancing VFU functionality, usability, and processes of care and communication workflows will improve patient perceptions of the patient centeredness and effectiveness of virtual care.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 355.2KB, Terms of use)
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- Publisher copy:
- 10.2196/65148
Authors
- Funder identifier:
- https://ror.org/01gavpb45
- Grant:
- TT7 128272
- Publisher:
- JMIR Publications
- Journal:
- Journal of Medical Internet Research More from this journal
- Volume:
- 27
- Article number:
- e65148
- Publication date:
- 2025-01-03
- Acceptance date:
- 2024-11-07
- DOI:
- EISSN:
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1438-8871
- ISSN:
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1438-8871
- Language:
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English
- Keywords:
- Pubs id:
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2075621
- Local pid:
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pubs:2075621
- Deposit date:
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2025-01-09
- ARK identifier:
Terms of use
- Copyright holder:
- Scruton et al.
- Copyright date:
- 2025
- Rights statement:
- © Sarah Scruton, Geoff Wong, Stephanie Babinski, Lauren R Squires, Alejandro Berlin, Julie Easley, Sharon McGee, Ken Noel, Danielle Rodin, Jonathan Sussman, Robin Urquhart, Jacqueline L Bender. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 03.01.2025. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research (ISSN 1438-8871), is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.
- Licence:
- CC Attribution (CC BY)
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