Author Identifier
Date of Award
2026
Keywords
patient experience, home-based, immunotherapy, infusions, home, patient, experience, Perth, Western Australia, nursing, chemo@home
Document Type
Thesis
Publisher
Edith Cowan University
Degree Name
Doctor of Philosophy (Integrated)
School
School of Nursing and Midwifery
First Supervisor
Lisa Whitehead
Second Supervisor
Deborah Kirk
Third Supervisor
Minh Nguyen
Abstract
Context: The treatment of cancer and chronic health conditions has been greatly revolutionised via intravenous immunotherapy infusions. Demand, both globally and in Australia, is increasing due to several factors including aging and increased populations, subsequent increases of cancer cases, new immunotherapy indications and increased survival rates.
In Perth, Western Australia, a private service provider commenced delivering a home based immunotherapy infusions model of care as a hospital substitution service provider in 2013 and the service has now been extended across Australia. The safety and efficacy of home-based infusions have been well documented in research, and an increasing number of patients are opting for immunotherapy infusions at home. However, the literature on their experiences and the impacts upon their lives remain scarce. As the main consumer of the service and a key stakeholder, patient voices need to be better acknowledged and considered in regard to the future planning of immunotherapy infusion healthcare.
Aim: This study explores patient experiences of receiving home-based immunotherapy infusions and to better understand how their lives are impacted by receiving their infusions at home.
Methods: This study is approved by Edith Cowan University’s Human Research Ethics Committee and uses a Constructivist Grounded Theory methodology. Accordingly, 18 in depth, semi-structured interviews were conducted with patients who were receiving home based immunotherapy infusions for cancer (n=8) and chronic disease (n=10), via private hospital-in-the-home service provider chemo@home, between July 2017 to September 2020.
Findings: The use of Constructivist Grounded Theory has ultimately led to the construction of the More Than Just Convenience theory comprised of seven defined key concepts conceptualising a framework by which to explain the experiences of, and impact upon, participants who received the home-based immunotherapy infusion model of care.
The seven concepts constructed from participant data are:
- Extant disease management burdens to participants associated with their finite resources of time, energy and money.
- The view that immunotherapy medication for serious illnesses as Just another drug, not appreciating the unique and differing potential adverse reaction profile.
- The Praised for nurses of both models of care, but noted that the hospital model of care adversely affected their connection and trust with nursing staff.
- Relief of burdens associated with hospital-based model of care —physical, emotional, family, environmental and financial—and the enormous relief provided to participants by receiving home-based treatment
- Significant Additional value, in terms of privacy, trust, self-identity, sense of safety and well-being, a sense of normality, autonomy and empowerment was obtained from receiving home-based immunotherapy infusions.
- Supported capacity of participants to Conserve their Resources and manage their disease when receiving home-based model of care.
- Participants ultimate experience of Dignity in the person-centred, home-based model of care.
Discussion: There is a dearth of available information related to patients’ experiences regarding home based immunotherapy treatment for cancer and chronic illness such as multiple sclerosis and inflammatory bowel diseases. Specific immunotherapies have only become widely available in Australia since 2012 and have mostly been administered in the hospital setting, via the traditional medical model of care.
This study’s novel Constructivist Grounded Theory More Than Just Convenience aligns with the limited existing literature recognising patient preferences and satisfaction for the home-based infusions service. In-depth insights extend knowledge by demonstrating the impact of the home-based immunotherapy infusion model of care which ultimately provides Dignity in Care – so much more than simple convenience. This home-based immunotherapy infusion theory aligns with well-used nursing frameworks Maslow’s Hierarchy of Needs, Patient Centred Care and the What Matters to You? approach.
Conclusion: This study presents the previously underrepresented and undocumented voices of patients receiving home-based immunotherapy infusions for chronic disease and cancer. In this study, participants overwhelmingly appreciated the significant additional value to their lives from the home-based infusion model of care; and rejected the detrimentally burdensome impacts of hospital-based infusions model of care.
Recommendations: Participants in this study desired autonomy, choice and access to home-based infusions. They represent the voices of the major stakeholders in infusion treatment and can be used to advise health care policy and decision-makers on home-based infusion care delivery. The findings in this study may be used to develop evidence-based policies to support patient centred, home-based care models. Accordingly, home-based immunotherapy and chemotherapy infusions should be presented as a standard option for patients, while burdensome (and expensive) hospital infusion treatments should be reserved for patients who are not suitable for home-based infusion treatment.
Recommended Citation
Cook, P. A. (2026). Patient experiences of receiving home-based immunotherapy infusions - A Constructivist Grounded Theory Study. Edith Cowan University. https://doi.org/10.25958/hcnt-1496