Time toxicity in cancer care: A concept analysis using Walker and Avant's method

Objective

The purpose of this concept analysis was to explore and clarify the concept of time toxicity in the context of cancer care using Walker and Avant's method, identify its defining attributes, antecedents, and consequences, and explore its implications for cancer care.

Methods

Walker and Avant's eight-step method was employed to analyze time toxicity. The literature was reviewed, focusing on peer-reviewed articles, grey literature, and cancer care policy documents to identify the defining attributes, antecedents, consequences, and empirical referents of time toxicity. Contextual factors, such as health care infrastructure and socioeconomic status, shape the manifestation of time toxicity in different patient populations. Model, borderline, and contrary cases were developed to clarify the concept further.

Results

Time toxicity is characterized by its defining attributes of temporal burden, disruption of daily life, cumulative effect, opportunity cost, and emotional strain. Antecedents include cancer diagnosis, complex treatment regimens, and health care inefficiencies, while consequences involve reduced quality of life, non-adherence to treatment, and economic strain. Empirical referents include time logs, patient-reported outcomes, and health care utilization data.

Conclusions

Our findings underscore the multidimensional nature of time toxicity and its significant implications for cancer patients’ well-being. Importantly, we highlight the vital role of oncology nurses in mitigating its effects through care coordination and patient support, thereby making our research directly applicable to clinical practice.