Are healthcare professionals being left in the lurch? The role of structural barriers and information resources to promote physical activity to cancer patients

Haussmann, Alexander; Ungar, Nadine; Gabrian, Martina; Tsiouris, Angeliki; Sieverding, Monika; Wiskemann, Joachim; Steindorf, Karen

doi:10.1007/s00520-018-4279-x

Cited by 36 publications

(52 citation statements)

References 38 publications

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“…If PA roles are assigned sensibly, this may help to accommodate certain barriers to PA promotion that have been reported by healthcare professionals working with cancer patients, e.g. lack of consultation time, or not wanting to overwhelm the patient [67][68][69] ; worry about undermining the relationship with the patient 68 ; and lacking confidence in providing PA advice. 68,70 Reports also suggest that there may be a significant educational need amongst health care professionals in this regard, 70,71 which could be considered a secondary barrier for patients.…”

Section: The Potential For a Bidirectional Facilitative Relationshimentioning

confidence: 99%

Barriers and facilitators to physical activity in men with prostate cancer: A qualitative and quantitative systematic review

et al. 2019

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Objective Existing research indicates that moderate‐to‐vigorous physical activity (PA) alleviates treatment side effects and is associated with survival in men with prostate cancer. We aimed to ascertain the state of research investigating barriers and facilitators to PA in men with prostate cancer and synthesise existing qualitative research on this topic. Methods A systematic review of qualitative and quantitative studies was conducted. MEDLINE, Embase, PsycINFO, Web of Knowledge, CINAHL, PEDro, OATD, and WorldCat were searched to June 2019 for quantitative studies investigating causes or predictors of PA or qualitative studies describing patient‐reported barriers/facilitators to PA, amongst men with prostate cancer of any stage. Thirty‐two studies (n = 17 quantitative; n = 15 qualitative) were included from 3698 screened articles. Results Heterogeneity and unsystematic reporting of quantitative study methods prohibited a quantitative data synthesis. Thematic synthesis of qualitative studies produced five analytical themes: individual needs by treatment pathway, self‐determination and its relationship with prostate cancer‐related events, co‐ordination and support of the clinical care team, individual preferences in discrete aspects of PA engagement style, and the potential for a bidirectional facilitative relationship between structured group PA and spontaneous peer support. Both qualitative and quantitative studies indicated incontinence as a barrier. Conclusions Unsystematic reporting of interventions hinders a robust quantitative understanding of behavioural intervention research in this subject area. Good co‐ordination of multidisciplinary care personnel could facilitate PA, by enabling a more comprehensive approach to targeting social cognitive processes. Well‐timed intervention and access to highly individualised PA support, including optional group PA classes, seem to also be important facilitators.

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Section: The Potential For a Bidirectional Facilitative Relationshimentioning

confidence: 99%

Barriers and facilitators to physical activity in men with prostate cancer: A qualitative and quantitative systematic review

et al. 2019

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“…As indicated in previous studies, they often claim a lack of time, do not feel qualified to discuss PA with their patients, desire more guidance for counseling and report limited knowledge on where to refer patients for an exercise program 20,26,28 . These concerns need to be in people with cancer in previous studies 16,17 .…”

Section: Discussionmentioning

confidence: 98%

The association between physicians’ exercise counseling and physical activity in patients with cancer: Which roles do patients’ satisfaction and previous physical activity levels play?

et al. 2020

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Objectives: The purpose of this study was to examine the association between physicians' exercise counseling and post-diagnosis physical activity (PA) in patients with cancer by investigating the mediating role of patients' satisfaction with exercise counseling as well as the moderating role of patients' previous PA. Methods: The study sample consisted of 1002 people with cancer (503 breast, 265 prostate, and 234 colorectal cancer). Participants reported their pre-and postdiagnosis moderate-to-vigorous PA (MVPA) levels, indicated whether their physician had covered different steps of exercise counseling as defined by the 5A framework (Assess, Advise, Agree, Assist, and Arrange) and rated their satisfaction with exercise counseling. A conditional process analysis was used to determine the direct and indirect effects of counseling on post-diagnosis MVPA through satisfaction at different levels of pre-diagnosis MVPA. Results: Physicians' exercise counseling was associated with post-diagnosis MVPA in patients with cancer. However, the association differed by patients' pre-diagnosis MVPA (P = .039). While counseling was directly associated with higher postdiagnosis MVPA for individuals with low pre-diagnosis MVPA (CI: 0.02-0.20, P = .014), the effect was mediated through satisfaction with exercise counseling for previously highly active individuals (Boot CI: 0.01-0.08). Conclusions: Our findings emphasize the relevance of physicians' exercise counseling for PA in patients with cancer. However, the results indicate that in order to effectively influence patients' PA, it appears important to provide a comprehensive counseling that is adjusted to the patients' exercise experiences.

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“…Dennoch sind Krebspatienten während und nach der Therapie überwiegend nur gering körperlich aktiv [6,7]. Wenngleich sich das Wissen zum Potenzial von Bewegung zunehmend in den klinischen Disziplinen verbreitet, fehlen für eine patientenorientierte Weitergabe häufig Kenntnisse über adäquate Angebote sowie spezifische Kompetenzen für die Beratung [8]. Während der Therapie scheinen Informationen zum Thema Bewegung für Patienten oftmals nicht sichtbar zu sein [9].…”

Section: Introductionunclassified

Ambulante Rehabilitationssportangebote für Krebspatienten: Eine Befragungsstudie zu Barrieren und Zugangswegen

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Middelmann

et al. 2020

TumorDiagnostik & Therapie

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Zusammenfassung Hintergrund Trotz einer steigenden Anzahl an Rehabilitationssportgruppen für Krebspatienten wird häufig von Schwierigkeiten beim Zugang zu entsprechenden wohnortnahen Angeboten berichtet. Ziel der Untersuchung war daher die Erhebung von Zugangswegen sowie wahrgenommenen Barrieren und Einflussgrößen für den Einstieg und die langfristige Teilnahme am Rehabilitationssport für Krebspatienten. Methode An der quantitativen und qualitativen Befragung beteiligten sich 189 Teilnehmer aus 21 ambulanten Rehabilitationssportgruppen (63 ± 10 Jahre; 96 % weiblich; 82 % Brustkrebs; Rehasport-Teilnahme seit im Median 29 Monaten). Mittels standardisierten Instruments (offene und geschlossene Fragen, validierte Skalen) wurden systematisch Faktoren erfasst, die Einstieg und Teilnahme am Rehabilitationssport potenziell beeinflussen können (z. B. Barrieren, Motive). Ergebnisse Vor dem Einstieg hatten 151 (80 %) der Befragten eine Empfehlung für die Teilnahme am Rehabilitationssport bekommen (40 % stationäre Rehabilitation/Anschlussheilbehandlung, 24 % Familie/Freunde, 16 % Onkologe, 11 % Personal der onkologischen Einrichtung, 10 % Hausarzt/Gynäkologe). Hindernisse / Bedenken vor dem Einstieg umfassten insbesondere eine als zu stark wahrgenommene Müdigkeit/Erschöpfung (37 %), zu starke Schmerzen/Unwohlsein (15 %) und das Gefühl einer therapie-/erkrankungsbedingt zu geringen Fitness (14 %) sowie fehlende Kenntnisse über passende Angebote (19 %) und unzureichende Empfehlungen (13 %). Primäre Motive für den Einstieg und die Teilnahme am Rehabilitationssport lagen in einer Verbesserung von Gesundheit und Wohlbefinden (97 bzw. 93 %) sowie einer Reduktion von (Krankheits-) Beschwerden (96 %) und Rezidivrisiko (82 %). Fast alle Teilnehmer (n = 185; 98 %) wollen nach der Teilnahme am Rehasport weiterhin regelmäßig körperlich-sportlich aktiv bleiben (74 % im Sportverein, davon 36 % zusätzlich privat, 17 % ausschließlich privat). Gut 2 / 3 der Befragten (68 %) haben Interesse, an weiteren regulären Vereinssportangeboten teilzunehmen, 38 % kennen keine anderen Angebote bzw. Möglichkeiten im Verein. Diskussion Konkrete Empfehlungen und adäquate Aufklärung über Durchführbarkeit, Nutzen und Möglichkeiten von Rehabilitationssport scheinen für den Einstieg in eine entsprechende Krebssportgruppe relevant. Informationen zu Angeboten und Möglichkeiten, bestenfalls bereits während der Krebstherapie, könnten den Einstieg in den Rehasport und konsekutiv einen aktiven Lebensstil sowie die Nutzung des Potenzials von Bewegung unterstützen.

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Are healthcare professionals being left in the lurch? The role of structural barriers and information resources to promote physical activity to cancer patients

Cited by 36 publications

References 38 publications

Barriers and facilitators to physical activity in men with prostate cancer: A qualitative and quantitative systematic review

Barriers and facilitators to physical activity in men with prostate cancer: A qualitative and quantitative systematic review

The association between physicians’ exercise counseling and physical activity in patients with cancer: Which roles do patients’ satisfaction and previous physical activity levels play?

Ambulante Rehabilitationssportangebote für Krebspatienten: Eine Befragungsstudie zu Barrieren und Zugangswegen

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