Background: COVID-19 presents a significant challenge to providing specialized rehabilitation and exercise for patients with breast cancer. Objective: The purpose of this report is to describe the implementation of telerehabilitation for one-on-one patient care and interactive, live, Web-based formats for group patient education, exercise, and support programs during the COVID-19 pandemic. Design: This report describes the concept, materials, and methods used in a community-based clinical setting to serve patients' needs during COVID-19. Results: Telerehabilitation and interactive Web-based strategies may be useful in meeting the physical and emotional needs of patients with breast cancer. Brief patient cases summarize the process of one-on-one telerehabilitation implementation and provide patient and family perspectives. Challenges and benefits of telerehabilitation are described. Interactive Web-based strategies substantially increased the numbers of patients reached with survivorship education and support groups during the first 2 months of COVID-19. Limitations: This report is descriptive and does not include group outcomes. Further research is needed to compare outcomes of telerehabilitation versus in-person delivery of breast cancer rehabilitation care. Conclusion: Telerehabilitation and interactive Web-based education formats provide an alternative to in-person breast cancer rehabilitation care during COVID-19 and have potential application for improving delivery of care to underserved populations and in other types of cancer.
Purpose Significant disparity exists in the diagnosis, treatment, and survivorship outcomes among Black breast cancer (BC) survivors. Black BC survivors have more significant survivorship issues and a greater burden of illness than White counterparts. Barriers to rehabilitation exist for all BC survivors but are magnified in Black BC survivors. The purpose of this qualitative research was to document patient, clinician, and researchers’ perceptions surrounding contributing factors, lived experiences, and potential solutions to racial disparity in BC survivorship. Methods A narrative approach was utilized to identify themes from a series of four virtual healthcare provider forums that explored lived personal and professional experiences, issues, and potential solutions surrounding racial disparity in BC survivorship. Forums included perspectives of patients, healthcare providers, researchers, and stakeholders in the BC field. An independent thematic analysis was performed by the investigators, all of whom have emic perspectives with respect to race and/or BC. Results Three main themes were identified related to racial disparity in BC survivorship: (1) societal and cultural contributing factors, (2) contribution of healthcare providers and systems, and (3) models of care and research considerations. Conclusions The findings provide compelling documentation of lived personal and professional experiences of racial disparity in BC survivorship. Potential solutions exist and must be enacted immediately to ensure equitable survivorship outcomes for Black individuals following a BC diagnosis. Implications for Cancer Survivors Increased awareness related to racial disparity in BC survivorship among survivors, healthcare providers, and researchers will contribute to health equity and improved outcomes for Black individuals.
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