Cancer during pregnancy: A qualitative study of healthcare experiences of Australian women

Abstract

Objectives: To identify features enhancing the quality of healthcare experiences for women with gestational cancer, and explore the impact of the heterogeneous Australian healthcare system on those experiences. Methods: Semi-structured, qualitative interviews were conducted with women diagnosed with any cancer during pregnancy in the last five years. Recruitment occurred during 2018-2019 via social media and professional, clinical and community networks. Questions related to women's experiences of their healthcare, wellbeing and psychosocial needs. Interviews were analysed thematically.Results: Study participants (n = 23) received treatment in the private sector (n = 10), public sector (n = 8), or both (n = 5). Five interview themes were found: Control over healthcare; Trust in clinicians, hospitals and systems; Coordination of care; An uncommon diagnosis; Holistic, future-oriented care. Women were most likely to have had a positive healthcare experience when (a)care was well-coordinated and adjusted to meet their unique needs/challenges, and (b)women perceived their care went beyond their immediate medical needs and encompassed future psychosocial wellbeing, including preparation for postpartum challenges.

Experiences of health professionals treating women diagnosed with cancer during pregnancy and proposals for service improvement

“…HPs highlighted that usual care is insufficient to meet these women's needs, and holistic care including psycho-social and antenatal needs must be prioritised. This is encouraging as recent patient accounts similarly emphasised that prioritised, tailored and holistic care that goes beyond medical treatment is supportive [4,15]. These findings are consistent with large-scale Australian research identifying serious service gaps in cancer supportive-and survivorship care across service providers and the need for more integrated, holistic, multidisciplinary care [1].…”

“…Ethics approval was received from The Royal Women's Hospital Research Ethics Committee (ID#18/25), with all participants providing informed consent. Findings on women's experiences and additional methodological details are published elsewhere [15,16]. Methodology details specific to collection of information from HP were as follows.…”

“…The role of comprehensive cancer care coordination in optimizing patient outcomes is recognised in Australia[7], but there is little research within the context of GC. The limited information available suggests that meeting the challenges of the complexity of care inherent in this group is central to perceived quality of care and wellbeing [4,14,15]. No previous study has investigated the experiences of the HPs treating this population; perspectives which are needed to better understand the barriers to comprehensive GC care.…”

What do we know about the psychosocial issues associated with cancer during pregnancy? A scoping review and gap analysis

“…Where it was accessed, there was emerging evidence that it might lessen the sense of isolation, recognising that digital information and peer forums may prove an important focus for future supportive care interventions in people affected by a cancer diagnosis during pregnancy. 34 …”

Women's experiences of gestational breast cancer and their interactions with the healthcare system: A scoping review

“…Delivering clinical information and providing adequate time is essential for women with GBC, as these define the direction of treatment, continuation of pregnancy and decision-making (Connell et al, 2006;Hammarberg et al, 2018;Ives, 2009;Kozu et al, 2020;Rodsten, 2017;Stafford et al, 2021;Zanetti-Dällenbach et al, 2006).…”