Organizing long-term follow-up care for pediatric cancer survivors: a socio-ecological approach
This study examines the organization of long-term follow-up care for pediatric cancer survivors through the lens of Bronfenbrenners’ Ecological Systems Theory (EST). Using focus group discussions with survivors and healthcare professionals across Germany, we aimed to identify challenges and facilita...
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| Published in: | Frontiers in public health Vol. 13; p. 1524310 |
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| Language: | English |
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| Abstract | This study examines the organization of long-term follow-up care for pediatric cancer survivors through the lens of Bronfenbrenners’ Ecological Systems Theory (EST). Using focus group discussions with survivors and healthcare professionals across Germany, we aimed to identify challenges and facilitators in care provision. Data were gathered during four focus groups, each consisting of 5–9 participants. A multimethods approach was used, employing both inductive and deductive thematic analysis. Results indicated key challenges such as fragmented care during transitions and insufficient offer of psychological support. The application of EST revealed the importance of coordinating care across multiple system levels: microsystem (direct care), mesosystem (coordination between care settings), exosystem (healthcare policies), and macrosystem (cultural attitudes). The study proposes strategies to improve care, such as implementing case managers and introducing culturally sensible long-term follow-up protocols. These findings highlight the complexity of survivorship care and the need for a more integrated approach to meet the evolving needs of survivors after childhood and adolescent cancer. |
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| AbstractList | This study examines the organization of long-term follow-up care for pediatric cancer survivors through the lens of Bronfenbrenners' Ecological Systems Theory (EST). Using focus group discussions with survivors and healthcare professionals across Germany, we aimed to identify challenges and facilitators in care provision. Data were gathered during four focus groups, each consisting of 5-9 participants. A multimethods approach was used, employing both inductive and deductive thematic analysis. Results indicated key challenges such as fragmented care during transitions and insufficient offer of psychological support. The application of EST revealed the importance of coordinating care across multiple system levels: microsystem (direct care), mesosystem (coordination between care settings), exosystem (healthcare policies), and macrosystem (cultural attitudes). The study proposes strategies to improve care, such as implementing case managers and introducing culturally sensible long-term follow-up protocols. These findings highlight the complexity of survivorship care and the need for a more integrated approach to meet the evolving needs of survivors after childhood and adolescent cancer. This study examines the organization of long-term follow-up care for pediatric cancer survivors through the lens of Bronfenbrenners' Ecological Systems Theory (EST). Using focus group discussions with survivors and healthcare professionals across Germany, we aimed to identify challenges and facilitators in care provision. Data were gathered during four focus groups, each consisting of 5-9 participants. A multimethods approach was used, employing both inductive and deductive thematic analysis. Results indicated key challenges such as fragmented care during transitions and insufficient offer of psychological support. The application of EST revealed the importance of coordinating care across multiple system levels: microsystem (direct care), mesosystem (coordination between care settings), exosystem (healthcare policies), and macrosystem (cultural attitudes). The study proposes strategies to improve care, such as implementing case managers and introducing culturally sensible long-term follow-up protocols. These findings highlight the complexity of survivorship care and the need for a more integrated approach to meet the evolving needs of survivors after childhood and adolescent cancer.This study examines the organization of long-term follow-up care for pediatric cancer survivors through the lens of Bronfenbrenners' Ecological Systems Theory (EST). Using focus group discussions with survivors and healthcare professionals across Germany, we aimed to identify challenges and facilitators in care provision. Data were gathered during four focus groups, each consisting of 5-9 participants. A multimethods approach was used, employing both inductive and deductive thematic analysis. Results indicated key challenges such as fragmented care during transitions and insufficient offer of psychological support. The application of EST revealed the importance of coordinating care across multiple system levels: microsystem (direct care), mesosystem (coordination between care settings), exosystem (healthcare policies), and macrosystem (cultural attitudes). The study proposes strategies to improve care, such as implementing case managers and introducing culturally sensible long-term follow-up protocols. These findings highlight the complexity of survivorship care and the need for a more integrated approach to meet the evolving needs of survivors after childhood and adolescent cancer. |
| Author | Gebauer, Judith Langer, Thorsten Calaminus, Gabriele Swart, Enno Baust, Katja Aleshchenko, Ekaterina |
| AuthorAffiliation | 3 Department of Pediatric Hematology and Oncology, University Hospital Bonn , Bonn , Germany 1 Faculty of Medicine, Institute of Social Medicine and Health Systems Research, Otto von Guericke University , Magdeburg , Germany 2 University Hospital of Schleswig-Holstein , Lübeck , Germany |
| AuthorAffiliation_xml | – name: 2 University Hospital of Schleswig-Holstein , Lübeck , Germany – name: 1 Faculty of Medicine, Institute of Social Medicine and Health Systems Research, Otto von Guericke University , Magdeburg , Germany – name: 3 Department of Pediatric Hematology and Oncology, University Hospital Bonn , Bonn , Germany |
| Author_xml | – sequence: 1 givenname: Ekaterina surname: Aleshchenko fullname: Aleshchenko, Ekaterina – sequence: 2 givenname: Thorsten surname: Langer fullname: Langer, Thorsten – sequence: 3 givenname: Gabriele surname: Calaminus fullname: Calaminus, Gabriele – sequence: 4 givenname: Judith surname: Gebauer fullname: Gebauer, Judith – sequence: 5 givenname: Enno surname: Swart fullname: Swart, Enno – sequence: 6 givenname: Katja surname: Baust fullname: Baust, Katja |
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| Copyright | Copyright © 2025 Aleshchenko, Langer, Calaminus, Gebauer, Swart and Baust. Copyright © 2025 Aleshchenko, Langer, Calaminus, Gebauer, Swart and Baust. 2025 Aleshchenko, Langer, Calaminus, Gebauer, Swart and Baust |
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| Keywords | ecological systems theory childhood cancer cancer survivorship long-term follow-up studies focus groups |
| Language | English |
| License | Copyright © 2025 Aleshchenko, Langer, Calaminus, Gebauer, Swart and Baust. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
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| SubjectTerms | Adolescent Aftercare - organization & administration Cancer Survivors - psychology cancer survivorship Child childhood cancer Continuity of Patient Care - organization & administration ecological systems theory Female Focus Groups Follow-Up Studies Germany Humans long-term follow-up studies Male Neoplasms - therapy Public Health Qualitative Research |
| Title | Organizing long-term follow-up care for pediatric cancer survivors: a socio-ecological approach |
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