The purpose of this study is to examine quality of care and patient safety in late effects cancer services for older adults, from the viewpoint of healthcare professionals in long-term follow-up clinics provided by Norwegian hospitals.
Based on an exploratory qualitative design, all hospital-based long-term follow-up clinics in Norway were recruited, and semi-structured interviews were conducted with oncologists (n = 4) and oncology nurses (n = 6). Thematic analyses were conducted.
Our findings demonstrate two overarching themes: vulnerability in service quality and safety for older adults with late effects; and circumstantial age discrimination in long-term follow-up clinics. Participants reported that the cohorts they care for often struggle longer with burdens from late effects (e.g. fatigue, diarrhea, neuropathy and pain). This negatively affects their quality of life and diminishes their level of functioning. The study highlights the fact that age-related changes and comorbidity often amplified late effects. Participants described how their patients frequently reported being overlooked by health services. Late-effect treatment of older adults was seen as needing special geriatric competence due to the complexity of comorbidity and age-related changes.
Long-term follow-up clinics in Norway are currently operating with marginal resources and financial insecurity, leading to priority dilemmas caused by external circumstances resulting in older adults being given a lower priority. This study contributes new knowledge on dimensions of high-quality care and safety that are highly relevant for organization of long-term cancer services.
