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Cancer care, Cancer care trajectories, Cancer coordination, Cancer coordinators, Cancer navigation, Coordinated care, Cross-sectoral collaboration, Primary healthcare, Qualitative research, Resources, Salutogenesis, System-level work



  1. Lie, Nataskja-Elena Kersting MSc
  2. Solvang, Per Koren PhD
  3. Hauken, May Aasebo PhD


Background: Cancer coordinators (CCs) operate at both patient and system levels in order to provide patients with tailored and coordinated services. In common with international CCs, Norwegian CCs denote notable progress in their patient-focused work, while reporting ongoing challenges in carrying out system-focused tasks. However, little is known about the barriers and facilitators for CCs' system-level work.


Objective: The aim of this study was to explore Norwegian CCs' experiences of barriers and facilitators for enacting system-focused tasks.


Methods: The study applies a qualitative method, conducting an interpretative data inquiry of semistructured in-depth interviews with 26 Norwegian CCs. The data were analyzed using thematic analysis and discussed in light of previous research and salutogenic theory.


Results: The analyses revealed 3 main themes: (1) "understanding the role and local cancer care," (2) "systems for care delivery in primary healthcare," and (3) "commitment to collaboration." Where present, the themes could represent important facilitators, whereas their absence could depict notable challenges to CCs system-focused work. Over time, as CCs were able to mobilize resources, they were able to gradually turn initial challenges into facilitators in the context of system-level work.


Conclusions: Cancer coordinators encounter cognitive, practical, and relational topics that impact their system-focused activities. Adopting a salutogenic focus can help CCs mobilize resources needed to turn challenges into facilitators for system-level work.


Implications for Practice: Cancer care coordination cannot be undertaken by CCs alone. Cancer coordinators' embedding in multidisciplinary teams, common systems for care provision, meaningful work relations, and professionals' commitment to cancer care represent important facilitators for CCs' system-focused tasks.