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Published on: February 16, 2011
Opportunities and Challenges of an Integrative Care Structure for Oncological Patients: A Qualitative Analysis of
Luis Scheck1,2, Jasmin Bossert1, Michel Wensing1
1Department of Primary Care and Health Services Research, University Hospital Heidelberg, Heidelberg University, Germany.
Introduction:
Considering the global increase in cancer, integrative medicine combines conventional and complementary methods, offering a holistic approach to treating cancer patients. To optimize care and support care continuity for oncological patients, the integrative healthcare structure CCC-Integrativ provided evidence-based, interprofessional counseling in four oncology centers in Southern Germany. A process evaluation explored the program's perceived effects and factors relevant to the implementation process to identify opportunities and challenges for a sustainable implementation of the program.
Methods:
In a qualitative study, semi-structured guide-based interviews with medical and nursing staff directly and indirectly involved in the program were conducted to explore their perspectives. The generated data were analyzed in a content analysis. Participant perceptions regarding potential program effects and factors influencing its' implementation were first identified through open inductive coding. The Consolidated Framework for Implementation Research (CFIR) was then used as a categorizing analytical framework to guide further coding and facilitate a deeper understanding of the implementation process.
Results:
N = 21 interviews were analyzed (n = 12 directly involved in counseling; n = 9 indirectly involved through leadership position). Participants perceived an added value of the integrative care approach and expressed a positive attitude towards a continuation of the program. Patient interest in complementary medicine and care, their positive response to the program, and a perceived supportive effect of the interprofessional collaboration were reported as promoting factors. Still, insufficient evidence and a perceived low acceptance of some complementary medicine methods by hospital staff, skepticism, lack of space, and recruitment problems, were identified as key challenges for successful long-term implementation.
Conclusions:
A variety of factors need to be addressed for sustained implementation. Promoting acceptance of supportive complementary methods is essential for evidence-based, patient-centered cancer care. Consideration of interprofessional care could be a key factor for the long-term implementation of consultations on complementary and integrative healthcare.
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