A proposed framework for “patient as a person” journey through a multi-level public healthcare system in accessing CT for localisation pre- radiation therapy treatment : a qualitative study

Abstract

IINTRODUCTION : Accessing radiation therapy treatment is a complex journey in the multilevel public healthcare system in South Africa. A framework was incorporated in this study to illustrate the interplay between a patient as a person journeying through the healthcare system, to the point of the computed tomography (CT) for localisation in pre-radiation therapy treatment series. METHODS : A qualitative inquiry, underpinned by hermeneutic phenomenological philosophical interpretation and analysis through semi-structured interviews, enabled acquiring insights into patients' expectations and experiences as they transited through the health system's processes and procedures of the CT for localisation in pre-radiation therapy treatment. FINDINGS : The participants' (patients) expectations of their anticipated radiation therapy localisation procedure and experience thereof were shaped and re-shaped by their recent and/or previous encounters within the multilevel public healthcare system. They shared their interactions with various healthcare professionals including diagnostic imaging examinations and/or management and treatment interventions and how these impacted on their quality of life. They adopted a passive, co-operative stance; a go with the flow of the system as uncertainty and the unpredictable disease were already complex to deal with. Despite the latter, they remained hopeful to undergo their upcoming radiation treatment so that they would be able to return to normalcy. CONCLUSION : The proposed framework illustrates the interdependence and interrelatedness of the public healthcare system's processes and procedures. Recommendation is to include each patient as a person's transitioning pathway through the healthcare system as part of seeking a solution to their problem in dealing with the unpredictable nature of their disease in order to regain a quality life. The experiences of cancer patients were sought in terms of what they encountered during their preparation stages for cancer treatment in a public sector healthcare system in South Africa.