Exploring the Barriers Related to the Healthcare System and Healthcare Professionals in Implementing Quality Intravenous Chemotherapy: A Qualitative Study

Abstract Purpose: This study aimed to explore barriers related to the healthcare system (HCS) and healthcare providers (HCPs) in implementing quality intravenous (IV) chemotherapy (CT) from the perspectives of cancer patients, family caregivers, and healthcare professionals.Methods: Using an explanatory descriptive qualitative method, this study was conducted in 2019. Forty-one participants (6 patients, 5 family caregivers, 12 oncologists, and 18 nurses) were selected through purposive sampling. In-depth semi-structured interviews were conducted to collect the data, which were analyzed using qualitative content analysis. Lincoln and Guba’s criteria of rigor were employed to ensure the trustworthiness of the study.Results: Data analysis showed two categories, each with three subcategories: Barriers related to HCPs that contains “educational and communication barriers”, “failure to establish trust” and “unskilled healthcare professionals”; Barriers related to the HCS, which consists of “inadequate physical and care infrastructures to provide services”, “lack of support in the disease trajectory from diagnosis to rehabilitation” and “mismanagement of CT wards/procedures”.Conclusion: The identification and removal of the barriers related to HCPs and HCS from routine care are crucial. Education of and communication with cancer patients and their family caregivers are two important pillars in the quality of intravenous chemotherapy (IV CT) and this education and communication should be based on individualized care and tailored to the unique needs of each patient.