Exploring the perceived need and anticipated feasibility of a proposed nurse-led telephone follow-up approach for breast cancer survivors in India: A convergent mixed methods study.
Abstract
Purpose
To examine the perceived need, acceptability and anticipated feasibility of the nurse-led telephone follow-up care (NLTFC) approach as an adjunct to specialist-led breast cancer follow-up in India from the perspectives of survivors and healthcare professionals.
Methods
A convergent, qualitatively driven mixed methods study (QUAL + quan). Semi-structured interviews were conducted with 21 survivors and 27 healthcare professionals (19 nurses, 8 doctors). Surveys were completed by 120 survivors and 112 healthcare professionals (96 nurses, 16 doctors). Qualitative data were analysed using reflexive thematic analysis, and quantitative data were summarised using descriptive statistics and exploratory Fisher's exact tests. Findings were integrated and reported through narrative weaving and a joint display.
Results
NLTFC received high survey-based support from survivors (99%), nurses (98%) and doctors (94%), with no statistically significant differences between nurses and doctors across the six perception statements. Participants perceived that NLTFC could improve accessibility, care coordination, psychosocial support and survivor empowerment while reducing travel, waiting times and financial burden. Despite the strong support, interviews identified concerns about clinical safety, nurses' preparedness and professional role boundaries. Structured follow-up plans, specialised oncology training, clearly delineated roles and multidisciplinary oversight were considered necessary for implementation.
Conclusion
NLTFC was perceived as an acceptable adjunct to specialist-led follow-up with potential to strengthen supportive care and redistribute specialist workload. The findings demonstrate anticipated rather than operational feasibility. Safe delivery would require formal clinical governance and investment in advanced oncology nursing roles. Prospective evaluation is required to assess feasibility, clinical safety, effectiveness and sustainability in India.