Between Ideal and Actual Care: Patients' and Family Carers' Experiences of Cancer Care Relationships.

Research on how patients and family carers experience their relationships with physicians and healthcare staff is limited, particularly regarding the gap between ideal expectations and actual care. This study explored patients' and carers' perceptions of the ideal care relationship, their lived experiences, and factors shaping discrepancies between expectations and reality. A total of 143 individual, face-to-face semi-structured interviews (mean age = 56.7 ± 13.2; 61.4% women) were conducted with 57 cancer patients and 86 family carers in outpatient oncology clinics in Southern Italy. Participants were recruited through purposive sampling and interviewed separately, with carers recruited as an independent group. Transcripts were analysed using Thematic Analysis of Elementary Contexts (TAEC), a mixed-methods approach combining qualitative and quantitative techniques. Methodological rigor and trustworthiness were ensured in line with COREQ reporting guidelines. Four thematic clusters emerged: "Variability in the experience," "The ideal care relationship," "Waiting times and delays in care," and "The luck of being cared for by a good physician." Oncology care experiences emerge as inherently ambivalent: supportive in interactions with clinicians, yet tension-laden due to systemic and organizational constraints. These findings suggest that strengthening patient- and family-centered care requires both relational improvements and organizational interventions aimed at reducing waiting times, enhancing care integration across fragmented pathways, and improving continuity of care.