Inhibitory factors and problems associated with uniform access to cancer care: Perceptions of certified nurse specialists in cancer nursing

Abstract

To elucidate the factors that obstruct uniform accessibility to care when oncology clinical nurse specialists (OCNSs) engage in medical care and to devise solutions for these obstructions. OCNSs enhance the quality of medical care, conduct activities as multidisciplinary coordinators, and provide public policy-related advice to maintain and improve the general population’s health. Therefore, OCNSs’ opinion is highly regarded, particularly in clinical setting. This study extracted and investigated the perceptions of OCNSs regarding factors inhibiting uniform access to care on the basis of a questionnaire with open-ended questions. Upon receiving the institutional review board’s approval, a questionnaire was distributed among 483 participants. Of these, 211 OCNSs affiliated with Core Oncology Centers who returned the filled questionnaire forms were enrolled. The recovery and effective response rates were 43.7% and 63.5%, respectively. Data were collected from the survey forms and subjected to qualitative and descriptive analyses. Inhibitory factors were categorized into the following five categories: (1) education and training systems; (2) medical specialties and workforce; (3) standard of medical care; (4) insufficient understanding on the part of administrators and the organization; and (5) policy. Each factor was further categorized into subcategories to elucidate the factors inhibiting universal access to care. Factors related to education and training systems affect factors related to medical specialties and manpower, leading to an imbalanced distribution of personnel between regions and facilities.