Background Growing evidence indicates patients’ survivorship outcomes can be enhanced through active engagement in a multi-modal cancer prehabilitation programme (MCPP), although this intervention is not uniformly embedded as a standard of care. MCPP aims to optimise patients physiologically and psychologically for cancer treatments, shorten recovery time, reduce complications, promote healthier lifestyles and improve quality of life. South Eastern Health and Social Care Trust (SET) developed and evaluated a system-wide collaborative approach to MMCP across three tumour groups (colorectal, lung, head and neck cancer). Addressing the lack of qualitative evaluation of MCPPs, this paper explores mechanisms promoting feasibility and acceptability of MCPP from patients’ and interdisciplinary professionals’ perspectives. Methods Semi-structured virtual one-to-one interviews were conducted with 24 interdisciplinary professionals and nine patients. Transcripts were recorded, transcribed verbatim and themes developed using Framework Analysis. Results Analysis of findings identified four themes providing an in-depth understanding of key elements required to develop and deliver a MCPP: 1) Planning: Building the team, 2) Shared vision to develop and tailor the MCPP to meet patient needs, 3) Delivering the MCPP and 4) Moving forward - improving the MCPP. Conclusion The system-wide collaborative approach to developing a MCPP at SET was deemed both feasible and acceptable. Success was attributed to visionary leadership, alongside a diverse group of interdisciplinary professionals being engaged, motivated and committed to improving patient outcomes. Iterative, responsive troubleshooting during delivery facilitated successful implementation. Greater adherence to provision of prescriptive high intensity exercise within the programme may further promote enhanced patient outcomes.
Sexual issues and treatment side effects are not routinely discussed with men receiving treatment for prostate cancer, and support to address these concerns is not consistent across settings. This study evaluates a brief e-learning resource designed to improve sexual wellbeing support and examine its effects on healthcare professionals’ sexual attitudes and beliefs. Healthcare professionals (n = 44) completed an online questionnaire at baseline which included a modified 12-item sexual attitudes and beliefs survey (SABS). Follow-up questionnaires were completed immediately after the e-learning and at 4 weeks. Data were analysed using one-way, repeat measures ANOVAs to assess change in attitudes and beliefs over time. Significant improvements were observed at follow-up for a number of survey statements including ‘knowledge and understanding’, ‘confidence in discussing sexual wellbeing’ and the extent to which participants felt ‘equipped with the language to initiate conversations’. The resource was seen as concise, relevant to practice and as providing useful information on potential side effects of treatment. In brief, e-learning has potential to address barriers to sexual wellbeing communication and promote delivery of support for prostate cancer survivors. Practical methods and resources should be included with these interventions to support implementation of learning and long-term changes in clinical behaviour.
Objectives: To adapt the theory-driven and positively evaluated Maximising Sexual Wellbeing| Prostate Cancer (MSW|PC) eLearning resource to an eLearning resource suitable for health professionals (HPs) working with mixed cancer populations; followed by usability and acceptability testing. Methods: Guided by Person-Based Approach (PBA) and Biopsychosocial Model, the MSW|PC was adapted by combining evidence from the literature, an expert group (n=27: patients, partners and HPs working in cancer care) and the research team. New content was developed relevant for a mixed cancer population. The Maximising Sexual Wellbeing| Cancer Care (MSW|CC) eLearning prototype was usability tested and modified with HPs using ‘think aloud’ interviews (n=18). Results: Many identified sexual challenges were common across cancer populations, with additional information required for breast, colorectal, gynaecological, head and neck and prostate cancers. During the testing phase, navigational difficulties were identified and resolved. HPs reported the MSW|CC as engaging, informative, relevant with helpful communication and signposting tools to support practice.Conclusion: This systematic and iterative PBA, yielded important insights to enhance the content and usability of MSW|CC. This novel resource provides HPs working across cancer care with tools to potentially address the gap in knowledge and skills and positively impact future sexual healthcare provision across cancer care.
Objective Barriers to healthcare professional (HP) (HP)‐led sexual support in cancer care include lack of knowledge, skills and evidence‐based educational interventions, to equip HPs to address sexual challenges faced by patients and partners. Consequently, sexual support is often avoided. This study examined HPs' acceptability and usability of the Maximising Sexual Wellbeing: Cancer Care (MSW|CC) eLearning resource for HPs and evaluated its impact on HPs' sexual attitudes and beliefs to providing sexual support in cancer care. Methods HPs (n = 87) completed pre and post‐test surveys using the modified 12‐item Sexual Attitudes and Beliefs Scale (SABS). Post‐test, participants rated acceptability and usability of the MSW|CC, with optional free‐text comments. A repeated measures t‐test assessed changes in HPs' scores on the SABS. Descriptive statistics and reporting of free text comments were used to explore HPs' perspectives of the MSW|CC. Results SABS scores increased significantly from Time 1 (M = 35.1, SD = 4.8) to Time 2 (M = 40.1, SD = 4.3), t (86) = −10.2, p < 0.001 (two‐tailed) with a medium effect size (d = 0.55); indicating a decrease in HPs' attitudinal barriers to providing sexual support. The MSW|CC was deemed acceptable, user‐friendly and easy to navigate. Healthcare professionals would recommend the use of this eLearning resource to others (3.78/4, SD = 0.5), considered it a good informational resource (3.78/4, SD = 0.5) and straightforward to use (3.8/4, SD 0.42). Discussion/Conclusion The MSW|CC reduced HPs' attitudinal barriers towards the provision of HP‐led sexual support in cancer care, whilst being acceptable and useable. The MSW|CC could support implementation of global clinical guidelines advocating for HP‐led sexual support across the treatment trajectory.
Objectives To adapt the theory-driven and positively evaluated Maximising Sexual Wellbeing| Prostate Cancer (MSW|PC) eLearning resource to an eLearning resource suitable for health professionals (HPs) working with mixed cancer populations, followed by usability and acceptability testing. Methods Guided by Person-Based Approach (PBA) and Biopsychosocial Model, the MSW|PC was adapted by combining evidence from the literature, an expert group ( n = 27: patients, partners, and HPs working in cancer care) and the research team. New content was developed relevant for a mixed cancer population. The Maximising Sexual Wellbeing| Cancer Care (MSW|CC) eLearning prototype was usability tested and modified with HPs using “think aloud” interviews ( n = 18). Results Many identified sexual challenges were common across cancer populations, with additional information required for breast, colorectal, gynaecological, head and neck, and prostate cancers. During the testing phase, navigational difficulties were identified and resolved. HPs reported the MSW|CC as engaging, informative, and relevant with helpful communication and signposting tools to support practice. Conclusion This systematic and iterative PBA yielded important insights to enhance the content and usability of MSW|CC. This novel resource provides HPs working across cancer care with tools to potentially address the gap in knowledge and skills and positively impact future sexual healthcare provision across cancer care. Supplementary Information The online version contains supplementary material available at 10.1007/s00520-022-06798-w.
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