Preparedness to Implement Physical Activity and Rehabilitation Guidelines in Routine Primary Care Cancer Rehabilitation: Focus Group Interviews Exploring Rehabilitation Professionals’ Perceptions

Neher, Margit; Ludvigsson, Maria Landén; Enblom, Anna

doi:10.1007/s13187-020-01704-6

Cited by 10 publications

(8 citation statements)

References 33 publications

(58 reference statements)

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“…Furthermore, the specific content and methods of rehabilitation interventions, such as how often, how long, and what kind of rehabilitation should be performed for these patients, are poorly documented. Therefore, rehabilitation therapists currently deliver treatment to patients based on their own experiences; this may cause differences in the quality of rehabilitation provided [26,27]. In addition, as many cancer patients become increasingly frail in the terminal phase [1,25], routine interventions might be harmful.…”

Section: Introductionmentioning

confidence: 99%

The efficacy of specialised rehabilitation using the Op-reha Guide for cancer patients in palliative care units: protocol of a multicentre, randomised controlled trial (JORTC-RHB02)

et al. 2020

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Background Although rehabilitation is recommended for terminal cancer patients, the specific components and methods of such programs are poorly documented. No studies to date have examined the effectiveness of rehabilitation for terminal cancer patients. This study aims to evaluate the efficacy of a new intervention for rehabilitation therapists, using the Op-reha Guide (Guide to Optimal and Patient-Centred Rehabilitation Practice for Patients in Palliative Care Units [PCUs]) in rehabilitation practice. This guide consists of recommended actions and attitudes for rehabilitation therapists and aims to optimise therapists’ actions according to the patient’s needs and condition. It shares goals with terminal cancer patients to maintain their activities of daily living (ADL). Methods This study uses a multicentre, prospective, randomised controlled trial (RCT) design with two parallel groups in PCUs where specialised rehabilitation will be routinely performed for terminal cancer patients by rehabilitation therapists. Participants will be randomised (1:1) to intervention (the Op-reha Guide) and control groups (usual rehabilitation). We will then conduct an observational study in PCUs that do not perform specialised rehabilitation for terminal cancer patients; this will be considered the usual care group, and the efficacy of usual rehabilitation will be quantitatively evaluated. Inclusion criteria are hospitalisation in PCU, European Cooperative Oncology Group Performance Status of 2 or 3, and clinical estimation of life expectancy of 3 weeks or more. Patients with severe symptom burden will be excluded. We hypothesise that the Op-reha Guide will be more effective in maintaining the ADL of terminal cancer patients hospitalised in PCUs than usual rehabilitation. The primary endpoint is defined as the change in (total) modified Barthel Index from baseline to Day 22. Quality of life will be a secondary endpoint. In total, 135 patients will be recruited from 16 Japanese sites between July 2019 and December 2021. Discussion This will be the first trial to evaluate the efficacy of specialised rehabilitation for terminal cancer patients hospitalised in PCUs, and will contribute to the evidence on the efficacy of implementing rehabilitation for terminal cancer patients. Trial registration UMIN-CTR, UMIN000037298 R000042525 (date of registration 7 July 2019).

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Section: Introductionmentioning

confidence: 99%

The efficacy of specialised rehabilitation using the Op-reha Guide for cancer patients in palliative care units: protocol of a multicentre, randomised controlled trial (JORTC-RHB02)

et al. 2020

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“…Primary care physicians frequently cite a lack of knowledge and training as a barrier to the promotion of PA 15–18,20–25,28–30,40–48 . A nationwide survey of 1013 GPs in England reported that only 20% were broadly familiar with the national PA guidelines, and 55% reported they had not undertaken any training in PA counselling or advice 9 .…”

Section: Methodsmentioning

confidence: 99%

“…Primary care physicians frequently cite a lack of knowledge and training as a barrier to the promotion of PA. [15][16][17][18][20][21][22][23][24][25][28][29][30][40][41][42][43][44][45][46][47][48] A nationwide survey of 1013 GPs in England reported that only 20% were broadly familiar with the national PA guidelines, and 55% reported they had not undertaken any training in PA counselling or advice. 9 A failure of medical school education in the United Kingdom was suggested by Weiler et al 49 in a review of medical school curricula.…”

Section: Knowledge/skillsmentioning

confidence: 99%

Narrative review – Barriers and facilitators to promotion of physical activity in primary care

2023

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The objective to provide an overview of the literature on the barriers and facilitators to physical activity (PA) promotion in primary care, as experienced by practitioners and patients. Method A search strategy of the English‐language literature was conducted in EMBASE, MEDLINE and the COCHRANE LIBRARY. Search terms were primary care OR general practice OR family medicine OR family practitioner AND physical activity OR exercise AND barriers OR facilitators. Databases were searched from inception until 21 October 2022. Results After screening, 63 articles were included within the summary and content analysis of this review. Analysis of the barriers to the implementation of PA highlighted four main themes perceived by practitioners: time, knowledge/skills, resources/support and financial implications. Analysis of the patient perspective identified themes which were categorised into individual (pre‐existing health conditions, knowledge of benefits of PA, time/capacity), societal (social support and cultural norms) and environmental (availability of facilities and weather). Conclusions As the importance of PA increases through the manifestation of sedentary behaviour‐related disease, a combined primary care and public health approach to increase PA is required. By identifying the main barriers to PA promotion in primary care, resources and funding can be directed to address this. This is particularly relevant in the United Kingdom, with the re‐negotiation of the primary care contract and the changes to healthcare delivery as a consequence of the Covid‐19 pandemic. Throughout this review, we have explored ways of addressing the identified barriers through evidence‐based interventions.

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“…According to the law, it is recommended that cancer rehabilitation takes place in survivors’ local community. However, programs in primary healthcare are criticized for being random, fragmented, not research based, and focusing on single components, and survivors are often left to find such programs on their own 34–36 . This highlights the need to develop and pilot evidence-based cancer rehabilitation programs in primary healthcare 37–40 .…”

Section: Introductionmentioning

confidence: 99%

“…However, programs in primary healthcare are criticized for being random, fragmented, not research based, and focusing on single components, and survivors are often left to find such programs on their own. [34][35][36] This highlights the need to develop and pilot evidence-based cancer rehabilitation programs in primary healthcare. [37][38][39][40] Most of the research on cancer rehabilitation is conducted on residential rehabilitation programs at specialist healthcare level, and it may seem apparent that multidimensional rehabilitation programs in primary healthcare should be built on the same principles.…”

Section: Introductionmentioning

confidence: 99%

A Qualitative Study of Cancer Survivors’ Experienced Outcomes of a Multidimensional Rehabilitation Program in Primary Healthcare

Løken

Hauken

2021

Cancer Nurs

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BackgroundCancer survival rates are increasing, but survival is often followed by several late effects. Cancer survivors’ need for complex rehabilitation is well documented, but this is mostly missing in primary healthcare.ObjectiveThe aim of this study was to explore cancer survivors’ experienced outcomes of a multidimensional rehabilitation program in primary healthcare.MethodsThe study used a qualitative method with a descriptive research design. Fifty-six cancer survivors completed a 12-week rehabilitation program built upon the 5 elements of goal setting, physical exercise, psychoeducation, individual follow-up, and peer support. Data were collected at the end of the program via 8 focus group interviews, and systematic text condensation was used to analyze the data.Results“Increased coping and participation” was identified as the overarching theme of the participants’ experienced outcomes from the program, and this was elaborated by 3 main themes: (1) “increased energy and capacity,” (2) “acceptance and understanding,” and (3) “structure and hope.”ConclusionThe multidimensional rehabilitation program seemed to address cancer survivors’ multiple challenges in survivorship. Proximity and accessibility to a local rehabilitation program and professionals’ competence seemed to be essential factors for the participants’ experienced outcomes of the program.Implication for PracticeA multidimensional rehabilitation program integrated in a Healthy Life Centre in primary healthcare may be beneficial for cancer survivors’ coping and participation in everyday life. Cancer nurses play a crucial role in initiating and facilitating such programs.

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Preparedness to Implement Physical Activity and Rehabilitation Guidelines in Routine Primary Care Cancer Rehabilitation: Focus Group Interviews Exploring Rehabilitation Professionals’ Perceptions

Cited by 10 publications

References 33 publications

The efficacy of specialised rehabilitation using the Op-reha Guide for cancer patients in palliative care units: protocol of a multicentre, randomised controlled trial (JORTC-RHB02)

The efficacy of specialised rehabilitation using the Op-reha Guide for cancer patients in palliative care units: protocol of a multicentre, randomised controlled trial (JORTC-RHB02)

Narrative review – Barriers and facilitators to promotion of physical activity in primary care

A Qualitative Study of Cancer Survivors’ Experienced Outcomes of a Multidimensional Rehabilitation Program in Primary Healthcare

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