Author: Alexandre Chan
Chan, Alexandre, 2025 Innovative Strategies to Improve Survivorship Care Across the Cancer Continuum, Flinders University, College of Nursing and Health Sciences
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Cancer survivorship is defined as the health and well-being of a person with cancer from the time of diagnosis through the end of their life. It aims to help people thrive after a cancer diagnosis and return to health or even improve their health and well-being. The number of people surviving with cancer is predicted to continue to rise due to a multitude of reasons, including early diagnosis, advances in cancer treatment, the growth and aging of the world population, and the increasing prevalence of risk factors. However, there are a number of unmet needs in cancer survivorship, such as the lack of patients’ and care providers’ perspectives, the lack of novel interventions for difficult-to-manage symptoms, and the lack of cultural adaptation to address disparities. Clinically relevant and novel strategies to optimize cancer survivorship are urgently needed.
To address the evolving needs in cancer survivorship, the overarching approach of this thesis is grounded in identifying and responding to the unmet needs of cancer survivors, applying a pragmatic, patient-centered approach to develop, evaluate, and implement novel interventions that directly address those needs. By aligning research with real-world clinical relevance, this thesis also explores the role of education in shaping the future of survivorship care, advocating the translation of research findings into university curriculum. The three specific aims of this thesis are: (1) to investigate the needs of cancer survivors from a patient and healthcare provider perspective; (2) to evaluate the impact of novel, multidisciplinary interventions, and implement them in routine care to address unmet needs of cancer survivors, and (3) to develop and evaluate an education-focused translational intervention embedding contemporary principles and research of survivorship care.
The overall structure of the thesis begins with an introduction of the current unmet needs surrounding cancer survivorship and the specific aims of the thesis (Chapter 1), followed by a discussion of the methodology and the methods (Chapter 2). The thesis then features six original research chapters (Chapters 3-8), with the first two chapters designed to gain insights from cancer survivors (Chapter 3) and healthcare professionals (Chapter 4) regarding unmet needs and strategies to optimize survivorship care. To address the specific unmet needs identified across diverse survivorship populations, Chapters 5 to 7 present distinct and innovative strategies to address the unmet needs within the treatment continuum. To examine the benefit of an undergraduate course on cancer survivorship, Chapter 8 describes the development and implementation of an education-focused translational intervention which embedded contemporary principles of survivorship care (Chapter 8). The thesis concludes with an in-depth discussion of the findings, along with concluding remarks (Chapter 9).
Collectively, the findings of the thesis highlight the interdisciplinary and patient-centered nature of survivorship care, emphasizing a holistic approach with three key strategies to address the unmet needs of cancer survivorship: (i) leveraging multidisciplinary teams, (ii) applying multilevel intervention designs, and (iii) utilizing culturally appropriate approaches to deliver survivorship care. Translating research findings related to cancer survivorship can enhance learners’ perceptions and awareness of the subject matter, underscoring the value of integrating foundational and practical cancer survivorship content into undergraduate education. Overall, this thesis emphasizes the value of conducting pragmatic research to meet the evolving needs of cancer survivors.
Keywords: cancer, cancer survivorship, supportive care, pragmatic research, implementation science, clinical trials
Subject: Nursing thesis
Thesis type: Doctor of Philosophy
Completed: 2025
School: College of Nursing and Health Sciences
Supervisor: Gillian Harvey