A qualitative approach to understanding quality symptom management in routine oncology outpatient care: phase 1 of the symptom pathways project

BACKGROUND: The quality of symptom management directly influences the quality of life and survival of patients, a and influences health service outcomes. There is an evidence practice gap between the known benefits of a structured approach to symptom management and how to operationalize high-quality symptom management as a part of routine oncology care. AIM: To understand practices and processes that influence the quality of symptom management, particularly the characteristics associated with high-quality symptom management. DESIGN: This work included two qualitative datasets: (i) qualitative focus groups with oncology nurses and (ii) qualitative interviews with specialist health professionals. Positive Deviance Theory informed the methods. SETTING/PARTICIPANTS: This study took place in an oncology outpatient department providing care to patients within a major hospital health service in Australia during June 2022 until August 2022. Oncology nurses and specialist health professionals were purposively recruited via email distribution lists and at general staff meetings. RESULTS: High-quality symptom management practices included early screening and assessment, interprofessional knowledge sharing, referral pathways to specialist teams, and flexible delivery of information to patients and carers. CONCLUSION: Quality symptom management may be optimized by drawing on the knowledge of healthcare teams providing symptom management.