Facilitators to oncological care in foregut cancer: The patient perspective.

Background: Foregut cancers are best treated by specialized, multidisciplinary care, often delivered, at least in part, at tertiary centers. Patient perspectives on the factors that enhance access to and adherence to cancer treatment remain underexplored. This qualitative study explores patient-reported facilitators of care at a safety-net hospital in the Southeastern United States (US). Methods: Patients with foregut cancer receiving care at a safety-net tertiary care institution in the Southeastern US were recruited. Interviews were recorded, transcribed, and analyzed using NVivo 14 Software. Grounded theory methodology was used to identify themes and subthemes. A comprehensive codebook was established, with a high interrater reliability rate of > 90 % for all themes. Results: Of the 30 patients interviewed, the majority were male (n = 23, 77 %) and Black (n = 18, 60 %), with an average age of 63 (IQR: 55-67). Facilitator themes were identified across four categories: (1) Individual/Interpersonal; (2) Provider/Care Team; (3) Healthcare Systems, and (4) Broader Policy. The most prevalent facilitators identified included faith and spirituality (87 %), support from immediate family (83 %), trust in the care team (90 %), and effective communication (97 %). Conclusion: Understanding patient perspectives is essential for delivering high-quality care in foregut cancer. These facilitators should be actively promoted during the development of future interventions. An appreciation of patient beliefs, communication training for care providers, hiring necessary ancillary staff, use of written handouts, expanding financial aid services, and wider healthcare reform are all avenues to explore in the ongoing effort to improve comprehensive oncological care for patients.