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Medina-Rincón A, San Miguel-Pagola M, Gargallo-Aguarón P, Roldán-Pérez P, Francín-Gallego M, Villa-García L, Buesa-Estéllez A. Exploring patients and caregivers needs and experiences in oncological physiotherapy: a call for collaborative care. Support Care Cancer 2024; 32:594. [PMID: 39155328 PMCID: PMC11330947 DOI: 10.1007/s00520-024-08782-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 08/01/2024] [Indexed: 08/20/2024]
Abstract
PURPOSE This study explores whether the full potential of physiotherapy is reaching cancer patients and their caregivers at all stages of the oncological process, aiming to identify gaps and opportunities for improving care. METHODS The World Cafe co-design methodology facilitated discussions among cancer patients and caregivers. This dynamic, inclusive, and engaging approach fostered diverse perspectives and deeper insights through collaborative and flexible discussions. Sessions were recorded, transcribed, and qualitatively analyzed. RESULTS Sixteen participants were involved (eight cancer survivors and eight caregivers). The mean age of cancer survivors was 63.8 years, while the average age of caregivers was 59.3 years. Breast cancer was the most prevalent diagnosis among patients, and most caregivers had lost their family members to cancer. Analysis revealed two primary themes: "feeling cared for" and "the role of physiotherapy in the oncological process." Key findings highlight the need for more humanized healthcare, with professionals providing support through effective communication and empathy. Significant gaps were detected in both systematic referrals to physiotherapists and their integration into care teams. Testimonies highlighted the lack of knowledge about the full potential of physiotherapy in oncology, hindering access. There was also a demand for recognizing specialized oncological physiotherapists. CONCLUSIONS These findings highlight significant gaps in physiotherapy care for cancer survivors and caregivers, including unmet needs due to the lack of information, resources, and effective communication. Future efforts should focus on increasing the visibility of physiotherapy, integrating specialized physiotherapists into oncology teams, and enhancing the emotional education of healthcare professionals to provide more humanized care.
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Affiliation(s)
- Almudena Medina-Rincón
- Universidad San Jorge, Campus Universitario, Autov A23 Km 299, 50830, Zaragoza, Villanueva de Gállego, Spain
| | - Marta San Miguel-Pagola
- Universidad San Jorge, Campus Universitario, Autov A23 Km 299, 50830, Zaragoza, Villanueva de Gállego, Spain.
| | - Pablo Gargallo-Aguarón
- Universidad San Jorge, Campus Universitario, Autov A23 Km 299, 50830, Zaragoza, Villanueva de Gállego, Spain
| | - Patricia Roldán-Pérez
- Universidad San Jorge, Campus Universitario, Autov A23 Km 299, 50830, Zaragoza, Villanueva de Gállego, Spain
| | - Marina Francín-Gallego
- Universidad San Jorge, Campus Universitario, Autov A23 Km 299, 50830, Zaragoza, Villanueva de Gállego, Spain
| | - Lorena Villa-García
- REFiT Aging Research Group, Parc Sanitari Pere Virgili and Vall d'Hebron Institute of Research (VHIR), Carrer d'esteve Terradas, 30 Gracia 08023, Barcelona, Spain
- Department of Public Health, Faculty of Nursing, Mental Health and Mother-Infant Nursing, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Almudena Buesa-Estéllez
- Universidad San Jorge, Campus Universitario, Autov A23 Km 299, 50830, Zaragoza, Villanueva de Gállego, Spain
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2
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Covington KR, Marshall T, Campbell G, Williams GR, Fu JB, Kendig TD, Howe N, Alfano CM, Pergolotti M. Development of the Exercise in Cancer Evaluation and Decision Support (EXCEEDS) algorithm. Support Care Cancer 2021; 29:6469-6480. [PMID: 33900458 DOI: 10.1007/s00520-021-06208-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 04/07/2021] [Indexed: 12/13/2022]
Abstract
PURPOSE Participation in exercise or rehabilitation services is recommended to optimize health, functioning, and well-being across the cancer continuum of care. However, limited knowledge of individual needs and complex decision-making are barriers to connect the right survivor to the right exercise/rehabilitation service at the right time. In this article, we define the levels of exercise/rehabilitation services, provide a conceptual model to improve understanding of individual needs, and describe the development of the Exercise in Cancer Evaluation and Decision Support (EXCEEDS) algorithm. METHODS From literature review, we synthesized defining characteristics of exercise/rehabilitation services and individual characteristics associated with safety and efficacy for each service. We developed a visual model to conceptualize the need for each level of specialized care, then organized individual characteristics into a risk-stratified algorithm. Iterative review with a multidisciplinary expert panel was conducted until consensus was reached on algorithm content and format. RESULTS We identified eight defining features of the four levels of exercise/rehabilitation services and provide a conceptual model of to guide individualized navigation for each service across the continuum of care. The EXCEEDS algorithm includes a risk-stratified series of eleven dichotomous questions, organized in two sections and ten domains. CONCLUSIONS The EXCEEDS algorithm is an evidence-based decision support tool that provides a common language to describe exercise/rehabilitation services, a practical model to understand individualized needs, and step-by-step decision support guidance. The EXCEEDS algorithm is designed to be used at point of care or point of need by multidisciplinary users, including survivors. Thus, implementation may improve care coordination for cancer exercise/rehabilitation services.
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Affiliation(s)
- Kelley R Covington
- ReVital Cancer Rehabilitation, Select Medical, Mechanicsburg, PA, USA. .,Department of Occupational Therapy, Colorado State University, Fort Collins, CO, USA.
| | | | - Grace Campbell
- Department of Acute & Tertiary Care, University of Pittsburgh School of Nursing, Pittsburgh, PA, USA.,Department of Occupational Therapy, University of Pittsburgh School of Health & Rehabilitation Sciences, Pittsburgh, PA, USA.,UPMC Hillman Cancer Center at UPMC Magee Women's Hospital, Pittsburgh, PA, USA
| | - Grant R Williams
- Department of Medicine, Division of Hematology/Oncology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jack B Fu
- Department of Palliative, Rehabilitation & Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Tiffany D Kendig
- ReVital Cancer Rehabilitation, Select Medical, Mechanicsburg, PA, USA.,Kessler Institute of Rehabilitation, West Orange, NJ, USA
| | - Nancy Howe
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | | | - Mackenzi Pergolotti
- ReVital Cancer Rehabilitation, Select Medical, Mechanicsburg, PA, USA.,Department of Occupational Therapy, Colorado State University, Fort Collins, CO, USA
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3
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Dolgoy N, Brose JM, Dao T, Suderman K, Gross DP, Ho C, Culos-Reed SN, McNeely ML. Functional, work-related rehabilitative programming for cancer survivors experiencing cancer-related fatigue. Br J Occup Ther 2021. [DOI: 10.1177/0308022620927351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction Cancer-related fatigue negatively impacts 50–90% of cancer survivors. In North America, approximately 50% of return-to-work interventions initially fail for survivors, with cancer-related fatigue often cited as a barrier to workability. Occupational therapy-driven cancer-related fatigue work-related programming for survivors is sparse, despite many published reviews calling for interdisciplinary interventions; to address work-related performance, specific functional interventions are likely to be needed. Further exploration and a broader understanding of survivors’ cancer-related fatigue management, participation in rehabilitative programmes, and plans for return to work are necessary to target survivor needs better. Method Drawing on social theory, this exploratory descriptive study utilised content and thematic analysis of interviews from 12 survivors to explore and describe the perspectives of survivors experiencing cancer-related fatigue yet desiring to work. Results Content analysis reflected distinct differences in fatigue-related terminology. Thematic analysis identified three themes specific to cancer-related fatigue and workability: valuing physical wellness, perceived cognitive impacts of cancer-related fatigue on function and workability, and the lack of transition from physical exercise to functional work-related activities. Conclusion Survivors identified gaps in care related to managing cognitive symptoms and the need for functional, work-related interventions to manage cancer-related fatigue. With their expertise in function, occupational therapists are well positioned to facilitate work-specific interventions, within cancer-specific exercise programming.
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Affiliation(s)
- Naomi Dolgoy
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Julie M Brose
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Thao Dao
- Department of Claims and Rehabilitation Services, WorkSafe BC, Victoria, Canada
| | - Kirsten Suderman
- Spinal Cord Injury Research Chair, University of Alberta, Edmonton, Canada
| | - Douglas P Gross
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Chester Ho
- Spinal Cord Injury Research Chair, University of Alberta, Edmonton, Canada
| | | | - Margaret L McNeely
- Spinal Cord Injury Research Chair, University of Alberta, Edmonton, Canada
- Cross Cancer Institute, Edmonton, Canada
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4
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LeBlanc MR, LeBlanc TW, Leak Bryant A, Pollak KI, Bailey DE, Smith SK. A Qualitative Study of the Experiences of Living With Multiple Myeloma. Oncol Nurs Forum 2021; 48:151-160. [PMID: 33600390 DOI: 10.1188/21.onf.151-160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To explore the ways in which multiple myeloma affects an individual's life in the modern treatment era. PARTICIPANTS & SETTING 15 individuals with multiple myeloma and 10 clinicians were recruited from two academic medical centers in the southeastern United States. METHODOLOGIC APPROACH Semistructured interviews were conducted with individuals with multiple myeloma and clinicians to explore the effect of a multiple myeloma diagnosis and treatment on individuals' lives. Transcribed interviews were analyzed using conventional content analysis. FINDINGS The following four themes emerged from the analysis. IMPLICATIONS FOR NURSING The treatment journey for those with multiple myeloma can be lifelong and may require frequent visits to an oncologist and, potentially, many successive lines of therapy. Life effects are far-reaching and long-term. Nurses should be aware of the interprofessional resources to help meet these individuals' needs. With thorough assessment, care planning, and education, nurses can play a key role in mitigating the negative effects of multiple myeloma and its treatment.
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5
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Kannisto K, Hirvonen E, Koivuniemi M, Teeri S, Asikainen P, Koivunen M. Daily functioning support - a qualitative exploration of rehabilitative approach in acute hospitalised care. Scand J Caring Sci 2021; 35:1342-1351. [PMID: 33394504 DOI: 10.1111/scs.12954] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 12/13/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Hospitalised patients are at risk of temporary or permanent loss of functioning which impacts their future independence. Implementation of a rehabilitative approach in everyday nursing in the acute care setting may produce good therapeutic results and promote independent daily living of patients. Thus, the aim of the study was to explore and understand the patterns of a rehabilitative approach in acute hospital wards from the perspective of interdisciplinary team members. Specifically, our aim was to identify the factors promoting and preventing a rehabilitative approach. METHOD We conducted four focus group interviews with 21 participants, including multidisciplinary team members from acute hospital wards. Data were analysed with conventional inductive content analysis. RESULTS The findings highlighted that the rehabilitative approach, as a personal way of working and personal working attitude, was a part of comprehensive nursing. The main goals of the rehabilitative approach were to support the physical functioning of the patients and their independent initiative and individuality during clinical care in hospital ward. The promoting and preventing factors that influenced the development of the rehabilitative approach consisted of personal factors, organisational factors and the physical settings of the hospital wards. CONCLUSION The findings of this study indicate that the rehabilitative approach in nursing focused on supporting the physical functioning, independence and self-confidence of the patient. The staff highlighted that interdisciplinary teamwork was one feature of the rehabilitative approach. The rehabilitative approach in nursing should be established as a part of everyday activity in clinical practice.
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Affiliation(s)
- Kati Kannisto
- Satakunta Hospital District, Pori, Finland.,SataDiag, Hospital District of Satakunta Public Utility of Diagnostic and Related Services, Pori, Finland
| | | | - Minna Koivuniemi
- Satakunta Hospital District, Pori, Finland.,Turku School of Economics, Pori, Finland
| | - Sari Teeri
- Satakunta University of Applied Sciences, Pori, Finland
| | - Paula Asikainen
- Satakunta Hospital District, Pori, Finland.,Nursing Science, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Marita Koivunen
- Satakunta Hospital District, Pori, Finland.,Department of Nursing Science, University of Turku, Turku, Finland
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6
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Davies CC, Gracey J. Thinking outside the box, bespoke cancer rehabilitation moving forward, what matters? PHYSICAL THERAPY REVIEWS 2020. [DOI: 10.1080/10833196.2020.1822141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Claire C. Davies
- Nursing and Allied Health Research Office, Baptist Health Lexington, Lexington, KY, USA;
| | - Jackie Gracey
- School of Health Science, Ulster University, Coleraine, UK
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7
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Suderman K, Dolgoy N, Yurick J, Sellar C, Nishimura K, Culos-Reed SN, Joy AA, McNeely ML. A Practical Approach to Using Integrated Knowledge Translation to Inform a Community-Based Exercise Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17113911. [PMID: 32492824 PMCID: PMC7312668 DOI: 10.3390/ijerph17113911] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/19/2020] [Accepted: 05/28/2020] [Indexed: 12/17/2022]
Abstract
Background: Our aim was to understand cancer survivor needs prior to, and following the Alberta Cancer Exercise (ACE) pilot randomized trial as a means to inform implementation of a province-wide cancer-specific, community-based exercise program. Methods: Questionnaires and semi-structured stakeholder engagement sessions were conducted with cancer survivors to explore preferences, barriers and facilitators/benefits at two timepoints: (1) pre-ACE: prior to initiation of the ACE pilot trial (n = 13 survivors and n = 5 caregivers); and (2) post-ACE: following participation in the ACE pilot trial (n = 20 survivors). Descriptive statistics were used to summarize quantitative data from questionnaires. Stakeholder engagement data were analyzed using a framework analysis approach. Emergent themes were then mapped to actionable outcomes. Results: Pre-ACE, survivors indicated a preference for exercise programs that were (1) supervised by exercise specialists knowledgeable about cancer, (2) included support from other health care providers, (3) were held in community locations that were easily accessible. Post-ACE, participants identified (1) a lack of exercise counseling from health care providers, (2) the need for earlier introduction of exercise in the care pathway, and (3) supported referral to exercise programming. Conclusions: An integrated knowledge translation approach identified actionable outcomes to address survivor needs related to exercise in clinical cancer and community-based contexts.
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Affiliation(s)
- Kirsten Suderman
- Department of Physical Therapy, University of Alberta, 2-50 Corbett Hall, Edmonton, AB T6G 2G4, Canada; (K.S.); (N.D.); (C.S.); (K.N.)
| | - Naomi Dolgoy
- Department of Physical Therapy, University of Alberta, 2-50 Corbett Hall, Edmonton, AB T6G 2G4, Canada; (K.S.); (N.D.); (C.S.); (K.N.)
| | - Janice Yurick
- Cross Cancer Institute, Alberta Health Services, 11560 University Avenue, Edmonton, AB T6G 1Z2, Canada; (J.Y.); (A.A.J.)
| | - Christopher Sellar
- Department of Physical Therapy, University of Alberta, 2-50 Corbett Hall, Edmonton, AB T6G 2G4, Canada; (K.S.); (N.D.); (C.S.); (K.N.)
| | - Kathryn Nishimura
- Department of Physical Therapy, University of Alberta, 2-50 Corbett Hall, Edmonton, AB T6G 2G4, Canada; (K.S.); (N.D.); (C.S.); (K.N.)
- Faculty of Kinesiology, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada;
| | - S. Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada;
| | - Anil A. Joy
- Cross Cancer Institute, Alberta Health Services, 11560 University Avenue, Edmonton, AB T6G 1Z2, Canada; (J.Y.); (A.A.J.)
| | - Margaret L. McNeely
- Department of Physical Therapy, University of Alberta, 2-50 Corbett Hall, Edmonton, AB T6G 2G4, Canada; (K.S.); (N.D.); (C.S.); (K.N.)
- Cross Cancer Institute, Alberta Health Services, 11560 University Avenue, Edmonton, AB T6G 1Z2, Canada; (J.Y.); (A.A.J.)
- Correspondence: ; Tel.: +1-780-248-1531
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8
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Stout NL, Brown JC, Schwartz AL, Marshall TF, Campbell AM, Nekhlyudov L, Zucker DS, Basen-Engquist KM, Campbell G, Meyerhardt J, Cheville AL, Covington KR, Ligibel JA, Sokolof JM, Schmitz KH, Alfano CM. An exercise oncology clinical pathway: Screening and referral for personalized interventions. Cancer 2020; 126:2750-2758. [PMID: 32212338 DOI: 10.1002/cncr.32860] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 02/19/2020] [Accepted: 02/25/2020] [Indexed: 01/01/2023]
Affiliation(s)
- Nicole L Stout
- Rehabilitation Medicine Department, National Institutes of Health Clinical Center, Bethesda, Maryland.,Hematology Oncology Department, Division of Cancer Prevention and Control, West Virginia University Cancer Institute, Morgantown, West Virginia
| | - Justin C Brown
- Cancer Metabolism Research Program, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana
| | - Anna L Schwartz
- School of Nursing, Northern Arizona University, Flagstaff, Arizona
| | | | - Anna M Campbell
- Sighthill Campus, Edinburgh Napier University, Edinburgh, Scotland
| | - Larissa Nekhlyudov
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - David S Zucker
- Swedish Cancer Rehabilitation Medicine Services, Swedish Cancer Institute, Swedish Health Services, Seattle, Washington
| | - Karen M Basen-Engquist
- Department of Behavioral Science, Division of Cancer Prevention and Population Science, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Grace Campbell
- University of Pittsburgh School of Nursing and Health and Rehabilitation Sciences, Pittsburgh, Pennsylvania
| | | | - Andrea L Cheville
- Department of Rehabilitation Medicine, Mayo Clinic, Rochester, Minnesota
| | - Kelley R Covington
- Cancer Rehabilitation Program, Select Medical, Mechanicsburg, Pennsylvania
| | | | - Jonas M Sokolof
- Department of Physical Medicine and Rehabilitation, New York University Langone Health, New York, New York
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9
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Raj VS, Pugh TM, Yaguda SI, Mitchell CH, Mullan SS, Garces NS. The Who, What, Why, When, Where, and How of Team-Based Interdisciplinary Cancer Rehabilitation. Semin Oncol Nurs 2020; 36:150974. [PMID: 31955923 DOI: 10.1016/j.soncn.2019.150974] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To review the key components necessary for successful application of rehabilitation principles to oncology survivors. DATA SOURCES Validated databases, including PubMed, MEDLINE, and Scopus. CONCLUSION Rehabilitation is an essential component of cancer care that addresses functional needs for oncology survivors and is best accomplished via an interdisciplinary team. Interdisciplinary care, provided by nursing, physiatry, rehabilitation therapy, and exercise physiology, are critical components for comprehensive intervention. Challenges exist in implementing services, but opportunity also exists within the post-acute care sector. IMPLICATIONS FOR NURSING PRACTICE Nurses play an important role in the screening, assessment, and treatment of cancer-related functional impairments.
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Affiliation(s)
- Vishwa S Raj
- Department of Physical Medicine & Rehabilitation, Carolinas Rehabilitation, Charlotte, NC; Department of Supportive Care, Levine Cancer Institute, Charlotte, NC.
| | - Terrence M Pugh
- Department of Physical Medicine & Rehabilitation, Carolinas Rehabilitation, Charlotte, NC; Department of Supportive Care, Levine Cancer Institute, Charlotte, NC
| | - Susan I Yaguda
- Department of Supportive Care, Levine Cancer Institute, Charlotte, NC
| | - Charles H Mitchell
- Department of Physical Medicine & Rehabilitation, Carolinas Rehabilitation, Charlotte, NC; Department of Supportive Care, Levine Cancer Institute, Charlotte, NC
| | - Sarah S Mullan
- Department of Supportive Care, Levine Cancer Institute, Charlotte, NC
| | - Natalie S Garces
- Department of Supportive Care, Levine Cancer Institute, Charlotte, NC
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10
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Suderman K, McIntyre C, Sellar C, McNeely ML. Implementing Cancer Exercise Rehabilitation: An Update on Recommendations for Clinical Practice. CURRENT CANCER THERAPY REVIEWS 2019. [DOI: 10.2174/1573394714666180730100432] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A growing body of research evidence supports the benefit of exercise for cancer survivors
both during and after cancer treatment. The purpose of this paper is to provide an update on
our previously published review in 2006 on the state of the evidence supporting exercise for survivors
of cancer as well as guidelines for integrating exercise programming in the cancer clinical
setting. First, we provide a brief overview on the benefits of exercise as well as preliminary evidence
supporting the implementation of community-based exercise programs. Second, we summarize
the principles and goals of exercise, and the identified barriers to exercise among cancer
survivors. Finally, we propose an interdisciplinary model of care for integrating exercise programming
into clinical care including guidelines for medical and pre-exercise screening, exercise
testing and programming considerations.
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Affiliation(s)
- Kirsten Suderman
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Carolyn McIntyre
- Exercise Medicine Research Institute and School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Christopher Sellar
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Margaret L. McNeely
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
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11
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Dolgoy ND, Krishnasamy M, McNeely ML. Uncertainty and sense‐of‐self as targets for intervention for cancer‐related fatigue. Eur J Cancer Care (Engl) 2019; 28:e13048. [DOI: 10.1111/ecc.13048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 03/02/2019] [Accepted: 03/25/2019] [Indexed: 11/29/2022]
Affiliation(s)
| | - Mei Krishnasamy
- Department of Nursing University of Melbourne and Victorian Comprehensive Cancer Centre, University of Melbourne Parkville Victoria Australia
| | - Margaret L. McNeely
- University of Alberta and Cross Cancer Institute, University of Alberta Edmonton Alberta Canada
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12
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Peters T, Erdmann R, Hacker ED. Exercise Intervention: Attrition, Compliance, Adherence, and Progression Following Hematopoietic Stem Cell Transplantation
. Clin J Oncol Nurs 2019; 22:97-103. [PMID: 29350710 DOI: 10.1188/18.cjon.97-103] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Exercise is widely touted as an effective intervention to optimize health and well-being after high-dose chemotherapy and hematopoietic stem cell transplantation.
. OBJECTIVES This article reports attrition, compliance, adherence, and progression from the strength training arm of the single-blind randomized, controlled trial Strength Training to Enhance Early Recovery (STEER).
. METHODS 37 patients were randomized to the intervention and participated in a structured strength training program introduced during hospitalization and continued for six weeks after release. Research staff and patients maintained exercise logs to document compliance, adherence, and progression.
. FINDINGS No patients left the study because of burden. Patients were compliant with completion of exercise sessions, and their adherence was high; they also progressed on their exercise prescription. Because STEER balances intervention effectiveness with patient burden, the findings support the likelihood of successful translation into clinical practice.
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13
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Tennison JM, Ngo-Huang A, Fu JB, Hill AE, Dibaj SS, Bruera E. Frequency and Characteristics of Recommendations from Interdisciplinary Outpatient Cancer Rehabilitation Monthly Team Meetings. PM R 2019; 11:252-257. [PMID: 30010049 DOI: 10.1016/j.pmrj.2018.06.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 06/26/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Ambulatory cancer rehabilitation programs vary widely in the types of services offered, and there is a lack of consistency with respect to the coordination of rehabilitation with oncologic treatment plans. There are no guidelines for outpatient interdisciplinary rehabilitation team meetings, and the types and characteristics of recommendations that a physiatrist can provide during these meetings have not been reported. OBJECTIVE To identify the frequency and characteristics of different types of recommendations that were derived through monthly interdisciplinary outpatient rehabilitation team meetings involving physiatrists, physical therapists, and occupational therapists. DESIGN Case series-descriptive study. SETTING Quaternary cancer center. PARTICIPANTS Outpatient rehabilitation cancer patients discussed during consecutive monthly team meetings. MAIN OUTCOME MEASURE(S) Frequency and characteristics of recommendations. RESULTS Over a 7-month period, there were 57 potential patients to be discussed, and 42 patients were discussed. Among the 42 patients, 30 received recommendations, which yields 71% of patients receiving at least 1 recommendation. Some patients required repeated discussions in different months; thus, a total of 71 discussions occurred and resulted in 51 recommendations. Out of the 71 discussions, 41 (58%) discussions resulted in recommendations such as coordination of care in 19 (37%) cases, physiatry clinic follow-up in 9 cases (18%), oncology clinic follow-up in 7 cases (14%), and orders for referrals to other health professionals were placed in 5 cases (10%). Thirty discussions (42%) did not result in any recommendations, with the most common reason being stable or having improved functional status. CONCLUSIONS In contrast to acute inpatient rehabilitation interdisciplinary weekly team meetings required by Centers for Medicare and Medicaid Services, there are no guidelines for outpatient interdisciplinary rehabilitation team meetings. Thus, the types and characteristics of recommendations that a physiatrist can provide during these meetings have not been previously reported. Regularly scheduled outpatient interdisciplinary cancer rehabilitation team meetings increase communication among rehabilitation specialists to identify outpatients experiencing barriers to therapy progress, provide recommendations to address those barriers, and reassess rehabilitation goals previously established. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Jegy M Tennison
- Department of Palliative, Rehabilitation, and Integrative Medicine, Unit 1414, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030
| | - An Ngo-Huang
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jack B Fu
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Anissa E Hill
- Department of Rehabilitation Services, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Seyedeh S Dibaj
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Eduardo Bruera
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
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14
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Garmy P, Jakobsson L. Experiences of cancer rehabilitation: A cross-sectional study. J Clin Nurs 2018; 27:2014-2021. [PMID: 29493832 DOI: 10.1111/jocn.14321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2018] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES To investigate the cancer rehabilitation experiences of working-age cancer survivors. BACKGROUND Cancer survivors have extremely complex needs, spanning physical, vocational and sexual domains. Although cancer rehabilitation services have been found to eliminate or reduce these strains, these services are often underutilised. DESIGN A cross-sectional study design was employed. METHODS A survey of persons over the age of 18 with a cancer diagnosis, enrolled in the Social Insurance Agency in a municipality in southern Sweden (n = 168, 68% women), was conducted. RESULTS Patients who used the cancer rehabilitation service (57%) were generally satisfied with it. Of participants, 26% reported not having received an offer of rehabilitation. Of those who reported that they received information about cancer rehabilitation services, most also reported that they received this information from a healthcare service professional (69%); for example, from the oncology nurse or the oncologist, whereas 20% claimed they received the information from the administrator of the Swedish Social Insurance Agency. A minority of children and family members of patients received support from the healthcare system. CONCLUSIONS More efforts should be taken to reach patients in need of cancer rehabilitation. Additionally, more attention should be directed towards family members and young children. RELEVANCE TO CLINICAL PRACTICE More than one in four patients claimed to not have received an offer of cancer rehabilitation, and an even greater number of patients claimed that their spouses and children had never received an offer for this service either. Hence, there is a communication barrier that needs to be overcome. Health providers should be aware that information needs to be repeated several times, and presented both orally and in writing.
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Affiliation(s)
- Pernilla Garmy
- Department of Health Sciences, Kristianstad University, Kristianstad, Sweden.,Department of Health Sciences, Clinical Health Promotion Centre, Lund University, Lund, Sweden
| | - Liselotte Jakobsson
- Department of Health Sciences, Kristianstad University, Kristianstad, Sweden
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Farley E, McCarthy L, Pergolotti M. Rehabilitation Strategies in Older Adult Oncology Patients: a Focus on Occupational and Physical Therapy. CURRENT GERIATRICS REPORTS 2017. [DOI: 10.1007/s13670-017-0228-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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