title: Follow-up care after breast cancer treatment: experiences and perceptions of service provision and provider interactions in rural Australian women.
abstract: OBJECTIVE
  This study aims to explore and examine experiences and perceptions of follow-up care (medical and psychosocial) after active treatment for breast cancer among women living outside major Australian cities.
  
  
  METHODS
  Twenty-five semi-structured telephone interviews were conducted. Participants also completed a brief questionnaire to collect demographic, diagnosis, and treatment information. Interviews were audio-recorded, transcribed, independently coded, and then thematically analysed.
  
  
  RESULTS
  Themes that emerged from the interviews centred on patient experiences and perceptions of follow-up service provision and provider interactions related to medical, psychosocial, and lifestyle (e.g., diet, physical activity) care. Many women perceived a marked decline in the quality and duration of follow-up consultations with clinicians in comparison to their initial treatment experiences. Several women experienced considerable overlap in follow-up care when multiple providers were involved resulting in 'unnecessary' time and travel costs. Generally, women experienced limited availability of medical providers in rural areas, resulting in a lack of continuity in care, exacerbated by limited communication and coordination between treating health professionals. Lastly, women perceived a lack of available psychosocial support and resources for rural breast cancer survivors in their areas.
  
  
  CONCLUSIONS
  Breast cancer survivors living outside major Australian cities have limited access to medical follow-up care, and psychosocial and lifestyle support programmes. There is a need for greater co-ordination of care between health professionals to improve communication and reduce patient and medical system burden. Finding solutions (such as eHealth options) could help to alleviate these barriers and improve follow-up care for rural breast cancer survivors.
authors.affiliation: School of Population Health, The University of Queensland, Cancer Prevention Research Centre, Herston, Queensland 4006, Australia. s.lawler@uq.edu.au
authors.forename: Sheleigh
authors.initials: S
authors.lastname: Lawler
authors.forename: Kym
authors.initials: K
authors.lastname: Spathonis
authors.forename: Jane
authors.initials: J
authors.lastname: Masters
authors.forename: Jon
authors.initials: J
authors.lastname: Adams
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Eakin
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia; D001943:Breast Neoplasms / Q000628:therapy*; D003266:Continuity of Patient Care; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D017060:Patient Satisfaction; D011369:Professional-Patient Relations; D012424:Rural Population; D017741:Survivors