title: What are the barriers of quality survivorship care for haematology cancer patients? Qualitative insights from cancer nurses.
abstract: OBJECTIVE
  Many haematological cancer survivors report long-term physiological and psychosocial effects beyond treatment completion. These survivors continue to experience impaired quality of life (QoL) as a result of their disease and aggressive treatment. As key members of the multidisciplinary team, the purpose of this study is to examine the insights of cancer nurses to inform future developments in survivorship care provision.
  
  
  METHODS
  Open text qualitative responses from two prospective Australian cross-sectional surveys of nurses (n = 136) caring for patients with haematological cancer. Data were analysed thematically, using an inductive approach to identify themes.
  
  
  RESULTS
  This study has identified a number of issues that nurses perceive as barriers to quality survivorship care provision. Two main themes were identified: the first relating to the challenges nurses face in providing care ('care challenges') and the second relating to the challenges of providing survivorship care within contemporary health care systems ('system challenges').
  
  
  CONCLUSIONS
  Cancer nurses perceive the nature of haematological cancer and its treatment and of the health care system itself, as barriers to the provision of quality survivorship care. Care challenges such as the lack of a standard treatment path and the relapsing or remitting nature of haematological cancers may be somewhat intractable, but system challenges relating to clearly defining and delineating professional responsibilities and exchanging information with other clinicians are not.
  
  
  CONCLUSIONS
  Addressing the issues identified will facilitate cancer nurses' provision of survivorship care and help address haematological survivors' needs with regard to the physical and psychosocial consequences of their cancer and treatment.
authors.affiliation: School of Nursing and Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
authors.forename: Danette
authors.initials: D
authors.lastname: Langbecker
authors.affiliation: School of Nursing and Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
authors.forename: Stuart
authors.initials: S
authors.lastname: Ekberg
authors.affiliation: School of Nursing and Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.|Cancer Nursing Professorial Precinct, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.
authors.forename: Patsy
authors.initials: P
authors.lastname: Yates
authors.affiliation: Department of Pharmacy, National University of Singapore, Singapore, Singapore.|Department of Pharmacy, National Cancer Centre, Singapore, Singapore.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Chan
authors.affiliation: School of Nursing and Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia. Raymond.Chan@health.qld.gov.au.|Cancer Nursing Professorial Precinct, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia. Raymond.Chan@health.qld.gov.au.|Centre for Research and Innovation, West Moreton Hospital and Health Service, Level 8, Tower Block, Ipswich Hospital, Ipswich, QLD, 4305, Australia. Raymond.Chan@health.qld.gov.au.
authors.forename: Raymond Javan
authors.initials: RJ
authors.lastname: Chan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D003144:Communication Barriers; D003266:Continuity of Patient Care / Q000592:standards*; D003430:Cross-Sectional Studies; D005260:Female; D019337:Hematologic Neoplasms / Q000401:mortality / Q000451:nursing* / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000451:nursing / Q000517:prevention & control; D024802:Nurse's Role; D009732:Nursing Care / Q000458:organization & administration / Q000592:standards; D011787:Quality of Health Care / Q000592:standards; D011788:Quality of Life; D015996:Survival Rate; D017741:Survivors / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Delivery of health care; Haematological cancer; Nurse; Post-treatment; Survivorship; Survivorship care models