Abstract
Background: The global increase in cancer prevalence, driven by an aging population and advancements in early diagnosis, has shifted oncological care from inpatient to outpatient settings. This transition highlights the need for proximity support for patients undergoing ambulatory antineoplastic treatment, with concerns for symptom management and disrupted continuity of care throughout the course of the disease.
To address these issues, the PESOA program, a structured ambulatory oncology nursing support initiative based upon the principles of Person-Centred Care (PCC) from the University of Gothenburg, is under development to improve patient well-being and ensure continuity of care within outpatient clinic setting.
Approach: The PESOA program follows a multi-phase design anchored in the Medical Research Council (MRC) framework for complex health interventions, enhanced by the Consolidated Framework for Implementation Research (CFIR) to address contextual determinants. Key program features include structured nursing consultations at treatment initiation, post-treatment teleconsultations, and continuous symptom monitoring. The project includes five phases: (I) core elements study, (II) intervention and tools adaptation, (III) feasibility evaluation, (IV) efficacy and implementation outcomes evaluation, and (V) long-term implementation. Co-designed with input from oncology nurses, patients, and an interdisciplinary advisory board, PESOA integrates PCC principles to ensure responsiveness, feasibility, and compliance to patient needs and preferences.
Expected Results: The leading team anticipates that PESOA program will positively impact patient outcomes, through improved symptom management, and satisfaction with care. Improved healthcare resource management is also expected, with potential decrease in emergency visits for unaddressed symptoms. Additionally, the program is projected to enhance job satisfaction among oncology nurses, as it provides a structured, supportive care model aligned with person-centred principles.
Implications: PESOA aims to establish a replicable model for integrated, patient-centred oncology care in ambulatory settings, combining in-person and telehealth support strategies. This approach is anticipated to improve continuity of care, improve symptom burden, and enhance overall patient well-being. Future steps include a pragmatic trial to assess long-term efficacy, cost-effectiveness, and to explore implications for broader healthcare settings.