title: Localized versus centralized nurse-delivered telephone services for people in follow up for cancer: opinions of cancer clinicians.
abstract: OBJECTIVE
  Telephone-delivered supportive care interventions hold potential as a sustainable, low-resource option to improve patients' outcomes. Such interventions may be delivered centrally or locally. There is limited information about clinicians' preferences for these alternative models of service delivery. This study investigated the views of cancer clinicians who had experience of a centralized model.
  
  
  METHODS
  Interviews were conducted with 16 surgeons and nurses across New South Wales, Australia, who had participated in a trial of a centralized telephone-based supportive care intervention. Content analysis was conducted. Data were analyzed inductively and responses organized into categories and then higher order themes.
  
  
  RESULTS
  All clinicians valued the role of telephone follow ups as they would allow patients to ask questions and receive reassurance. Clinicians believed these services could reduce hospital presentations and provide equity and standardized care, particularly to those outside metropolitan centers. Although clinicians accepted a centralized model of delivery would be cheaper, most (n = 15) indicated a preference for local delivery. This preference was based on the perception that local nurses would have superior knowledge of the local context. Despite the improved feasibility of a telephone-only service, clinicians felt some face-to-face contact with patients was essential. Key at-risk groups to target were identified. Clinicians acknowledged there could be overlap with cancer nurses locally requiring local decisions about implementation.
  
  
  CONCLUSIONS
  There was clear endorsement of additional telephone support with a preference for a local model of service delivery. The limited acceptability of centralized telephone-based supportive care interventions may restrict their uptake.
authors: Surgical Outcomes Research Centre, Sydney Local Health District and Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
authors: James D
authors: JD
authors: Harrison
authors: Ivana
authors: I
authors: Durcinoska
authors: Phyllis N
authors: PN
authors: Butow
authors: Kathryn
authors: K
authors: White
authors: Michael J
authors: MJ
authors: Solomon
authors: Jane M
authors: JM
authors: Young
mesh_terms: D001315:Australia; D005500:Follow-Up Studies; D006801:Humans; D015337:Multicenter Studies as Topic; D009369:Neoplasms / Q000451:nursing* / Q000628:therapy*; D024802:Nurse's Role; D010166:Palliative Care / Q000379:methods* / Q000592:standards; D016032:Randomized Controlled Trials as Topic; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000379:methods* / Q000592:standards; D013689:Telephone / Q000706:statistics & numerical data*
keywords: cancer nurse; colorectal cancer; follow-up care; supportive care; telephone