Optimizing Virtual Follow-Up Care: Realist Evaluation of Experiences and Perspectives of Patients With Breast and Prostate Cancer
BackgroundVirtual follow-up (VFU) has the potential to enhance cancer survivorship care. However, a greater understanding is needed of how VFU can be optimized. ObjectiveThis study aims to examine how, for whom, and in what contexts VFU works for cancer survivorsh...
Saved in:
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2025-01-01
|
| Series: | Journal of Medical Internet Research |
| Online Access: | https://www.jmir.org/2025/1/e65148 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841560606973362176 |
|---|---|
| author | Sarah Scruton Geoff Wong Stephanie Babinski Lauren R Squires Alejandro Berlin Julie Easley Sharon McGee Ken Noel Danielle Rodin Jonathan Sussman Robin Urquhart Jacqueline L Bender |
| author_facet | Sarah Scruton Geoff Wong Stephanie Babinski Lauren R Squires Alejandro Berlin Julie Easley Sharon McGee Ken Noel Danielle Rodin Jonathan Sussman Robin Urquhart Jacqueline L Bender |
| author_sort | Sarah Scruton |
| collection | DOAJ |
| description |
BackgroundVirtual follow-up (VFU) has the potential to enhance cancer survivorship care. However, a greater understanding is needed of how VFU can be optimized.
ObjectiveThis study aims to examine how, for whom, and in what contexts VFU works for cancer survivorship care.
MethodsWe conducted a realist evaluation of VFU among patients with breast cancer and prostate cancer at an urban cancer center during the COVID-19 pandemic. Realist evaluations examine how underlying causal processes of an intervention (mechanisms) in specific circumstances (contexts) interact to produce results (outcomes). Semistructured interviews were conducted with a purposive sample of patients ≤5 years after diagnosis. Interviews were audio-recorded and analyzed using a realist logic of analysis.
ResultsParticipants (N=24; n=12, 50% with breast cancer and n=12, 50% with prostate cancer) had an average age of 59.6 (SD 10.7) years. Most participants (20/24, 83%) were satisfied with VFU and wanted VFU options to continue after the COVID-19 pandemic. However, VFU impacted patient perceptions of the quality of their care, particularly in terms of its effectiveness and patient centeredness. Whether VFU worked well for patients depended on patient factors (eg, needs, psychosocial well-being, and technological competence), care provider factors (eg, socioemotional behaviors and technological competence), and virtual care system factors (eg, modality, functionality, usability, virtual process of care, and communication workflows). Key mechanisms that interacted with contexts to produce positive outcomes (eg, satisfaction) were visual cues, effective and empathetic communication, and a trusting relationship with their provider.
ConclusionsPatients value VFU; however, VFU is not working as well as it could for patients. To optimize VFU, it is critical to consider contexts and mechanisms that impact patient perceptions of the patient centeredness and effectiveness of their care. Offering patients the choice of in-person, telephone, or video visits when possible, coupled with streamlined access to in-person care when required, is important. Prioritizing and addressing patient needs; enhancing physician virtual socioemotional behaviors and technology competency; and enhancing VFU functionality, usability, and processes of care and communication workflows will improve patient perceptions of the patient centeredness and effectiveness of virtual care. |
| format | Article |
| id | doaj-art-1219e83802fe4ce9a869c6584a5c368d |
| institution | Kabale University |
| issn | 1438-8871 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | Journal of Medical Internet Research |
| spelling | doaj-art-1219e83802fe4ce9a869c6584a5c368d2025-01-03T21:01:18ZengJMIR PublicationsJournal of Medical Internet Research1438-88712025-01-0127e6514810.2196/65148Optimizing Virtual Follow-Up Care: Realist Evaluation of Experiences and Perspectives of Patients With Breast and Prostate CancerSarah Scrutonhttps://orcid.org/0009-0006-1260-2043Geoff Wonghttps://orcid.org/0000-0002-5384-4157Stephanie Babinskihttps://orcid.org/0000-0001-5623-8542Lauren R Squireshttps://orcid.org/0000-0002-6428-4466Alejandro Berlinhttps://orcid.org/0000-0002-1880-6905Julie Easleyhttps://orcid.org/0000-0002-1711-1343Sharon McGeehttps://orcid.org/0000-0002-0323-6372Ken Noelhttps://orcid.org/0000-0002-0455-2297Danielle Rodinhttps://orcid.org/0000-0001-8279-0621Jonathan Sussmanhttps://orcid.org/0000-0002-7702-8816Robin Urquharthttps://orcid.org/0000-0001-8864-5716Jacqueline L Benderhttps://orcid.org/0000-0003-1501-335X BackgroundVirtual follow-up (VFU) has the potential to enhance cancer survivorship care. However, a greater understanding is needed of how VFU can be optimized. ObjectiveThis study aims to examine how, for whom, and in what contexts VFU works for cancer survivorship care. MethodsWe conducted a realist evaluation of VFU among patients with breast cancer and prostate cancer at an urban cancer center during the COVID-19 pandemic. Realist evaluations examine how underlying causal processes of an intervention (mechanisms) in specific circumstances (contexts) interact to produce results (outcomes). Semistructured interviews were conducted with a purposive sample of patients ≤5 years after diagnosis. Interviews were audio-recorded and analyzed using a realist logic of analysis. ResultsParticipants (N=24; n=12, 50% with breast cancer and n=12, 50% with prostate cancer) had an average age of 59.6 (SD 10.7) years. Most participants (20/24, 83%) were satisfied with VFU and wanted VFU options to continue after the COVID-19 pandemic. However, VFU impacted patient perceptions of the quality of their care, particularly in terms of its effectiveness and patient centeredness. Whether VFU worked well for patients depended on patient factors (eg, needs, psychosocial well-being, and technological competence), care provider factors (eg, socioemotional behaviors and technological competence), and virtual care system factors (eg, modality, functionality, usability, virtual process of care, and communication workflows). Key mechanisms that interacted with contexts to produce positive outcomes (eg, satisfaction) were visual cues, effective and empathetic communication, and a trusting relationship with their provider. ConclusionsPatients value VFU; however, VFU is not working as well as it could for patients. To optimize VFU, it is critical to consider contexts and mechanisms that impact patient perceptions of the patient centeredness and effectiveness of their care. Offering patients the choice of in-person, telephone, or video visits when possible, coupled with streamlined access to in-person care when required, is important. Prioritizing and addressing patient needs; enhancing physician virtual socioemotional behaviors and technology competency; and enhancing VFU functionality, usability, and processes of care and communication workflows will improve patient perceptions of the patient centeredness and effectiveness of virtual care.https://www.jmir.org/2025/1/e65148 |
| spellingShingle | Sarah Scruton Geoff Wong Stephanie Babinski Lauren R Squires Alejandro Berlin Julie Easley Sharon McGee Ken Noel Danielle Rodin Jonathan Sussman Robin Urquhart Jacqueline L Bender Optimizing Virtual Follow-Up Care: Realist Evaluation of Experiences and Perspectives of Patients With Breast and Prostate Cancer Journal of Medical Internet Research |
| title | Optimizing Virtual Follow-Up Care: Realist Evaluation of Experiences and Perspectives of Patients With Breast and Prostate Cancer |
| title_full | Optimizing Virtual Follow-Up Care: Realist Evaluation of Experiences and Perspectives of Patients With Breast and Prostate Cancer |
| title_fullStr | Optimizing Virtual Follow-Up Care: Realist Evaluation of Experiences and Perspectives of Patients With Breast and Prostate Cancer |
| title_full_unstemmed | Optimizing Virtual Follow-Up Care: Realist Evaluation of Experiences and Perspectives of Patients With Breast and Prostate Cancer |
| title_short | Optimizing Virtual Follow-Up Care: Realist Evaluation of Experiences and Perspectives of Patients With Breast and Prostate Cancer |
| title_sort | optimizing virtual follow up care realist evaluation of experiences and perspectives of patients with breast and prostate cancer |
| url | https://www.jmir.org/2025/1/e65148 |
| work_keys_str_mv | AT sarahscruton optimizingvirtualfollowupcarerealistevaluationofexperiencesandperspectivesofpatientswithbreastandprostatecancer AT geoffwong optimizingvirtualfollowupcarerealistevaluationofexperiencesandperspectivesofpatientswithbreastandprostatecancer AT stephaniebabinski optimizingvirtualfollowupcarerealistevaluationofexperiencesandperspectivesofpatientswithbreastandprostatecancer AT laurenrsquires optimizingvirtualfollowupcarerealistevaluationofexperiencesandperspectivesofpatientswithbreastandprostatecancer AT alejandroberlin optimizingvirtualfollowupcarerealistevaluationofexperiencesandperspectivesofpatientswithbreastandprostatecancer AT julieeasley optimizingvirtualfollowupcarerealistevaluationofexperiencesandperspectivesofpatientswithbreastandprostatecancer AT sharonmcgee optimizingvirtualfollowupcarerealistevaluationofexperiencesandperspectivesofpatientswithbreastandprostatecancer AT kennoel optimizingvirtualfollowupcarerealistevaluationofexperiencesandperspectivesofpatientswithbreastandprostatecancer AT daniellerodin optimizingvirtualfollowupcarerealistevaluationofexperiencesandperspectivesofpatientswithbreastandprostatecancer AT jonathansussman optimizingvirtualfollowupcarerealistevaluationofexperiencesandperspectivesofpatientswithbreastandprostatecancer AT robinurquhart optimizingvirtualfollowupcarerealistevaluationofexperiencesandperspectivesofpatientswithbreastandprostatecancer AT jacquelinelbender optimizingvirtualfollowupcarerealistevaluationofexperiencesandperspectivesofpatientswithbreastandprostatecancer |