Evaluation of two strategies to implement physical cancer rehabilitation guidelines for survivors of abdominopelvic cavity tumors: a controlled before-and-after study.

Published on Sep 14, 2021in Journal of Cancer Survivorship4.442
· DOI :10.1007/S11764-021-01045-3
Charlotte IJsbrandy5
Estimated H-index: 5
(Radboud University Nijmegen),
Petronella B. Ottevanger30
Estimated H-index: 30
(Radboud University Nijmegen)
+ 2 AuthorsRosella P.M.G. Hermens32
Estimated H-index: 32
(Radboud University Nijmegen)
Sources
Abstract
This study evaluates the effectiveness and feasibility of two strategies to implement physical cancer rehabilitation (PCR) guidelines for patients who have survived abdominopelvic cavity malignancies. We tested and compared two tailored strategies to implement PCR guidelines for survivors of gastrointestinal, female organ and urogenital organ malignancies, in a clustered controlled before-and-after study. A patient-directed (PD) strategy was tested in five cancer centers, aiming to empower survivors. A multifaceted (MF) strategy was tested in four cancer centers, aiming additionally to influence healthcare professionals and the healthcare organization. Data were collected from existing registration systems, patient questionnaires and professional questionnaires. We measured both implementation- and client outcomes. For insight into the effectiveness we measured indicators related to PCR guidelines: (1) screening with the Distress Thermometer (DT) (=primary outcome measure), (2) information provision concerning physical activity (PA) and physical cancer rehabilitation programs (PCRPs), (3) advice to take part in PA and PCRPs, (4) referral to PCRPs, (5) participation in PCRPs, (6) PA uptake (PAU); and patient reported outcomes (PROs) such as (7) quality of life, (8) fatigue, and (9) empowerment. Furthermore, survivor and center determinants were assessed as possible confounders. Multilevel analyses were performed to compare the scores of the indicators of the PD and MF strategies, as well as the differences between the characteristics of these groups. The use of and experiences with both strategies were measured using questionnaires and Google Analytics to assess feasibility. In total, 1326 survivors participated in the study, 673 in the before- and 653 in the after-measurement. Regarding our primary outcome measure, we found a significant improvement of screening with the DT between the before- and after-measurement for both strategies, respectively from 34.2 to 43.1% (delta=8.9%; odds ratio (OR)=1.6706; p=0.0072) for the PD strategy and from 41.5 to 56.1% (delta=14.6%; OR=1.7098; p=0.0028) for the MF strategy. For both the primary and secondary outcomes, no statistically significant effect of the MF strategy compared to the PD strategy was observed. We found good use of and positive experiences with both strategies. Implementation strategies containing tools enhancing patient empowerment seem to be effective in increasing the systematic screening with the DT for survivors of abdominopelvic cavity malignancies. Further research is needed to assess the additional effectiveness of strategies that stimulate compliance among healthcare professionals and healthcare organizations. Using implementation strategies containing tools enhancing patient empowerment seem to be effective in increasing the systematic screening with the DT and might improve the quality of care of patients who have survived abdominopelvic cavity malignancies.
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#1Charlotte IJsbrandy (Radboud University Nijmegen)H-Index: 5
#2Petronella B. Ottevanger (Radboud University Nijmegen)H-Index: 30
Last. Rosella P.M.G. Hermens (Radboud University Nijmegen)H-Index: 32
view all 5 authors...
To tailor implementation strategies that maximize adherence to physical cancer rehabilitation (PCR) guidelines, greater knowledge concerning determinants of adherence to those guidelines is needed. To this end, we assessed the determinants of adherence to PCR guidelines in the patient and cancer center. We investigated adherence variation of PCR guideline-based indicators regarding [1] screening with the Distress Thermometer (DT), [2] information provision concerning physical activity (PA) and p...
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#1Charlotte IJsbrandy (Radboud University Nijmegen)H-Index: 5
#2Wim H. van Harten (UT: University of Twente)H-Index: 25
Last. Petronella B. Ottevanger (Radboud University Nijmegen)H-Index: 30
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Background The positive impact of physical activity programmes has been recognised, but the current uptake is low. Authorities believe delivering these programmes in a shared-care model is a future perspective. The present study aimed to identify the barriers and facilitators affecting physical activity programme implementation in a shared-care model delivered with the cooperation of all the types of healthcare professionals involved.
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#1Charlotte IJsbrandy (Radboud University Nijmegen)H-Index: 5
#2Rosella P.M.G. Hermens (Radboud University Nijmegen)H-Index: 32
Last. Petronella B. Ottevanger (Radboud University Nijmegen)H-Index: 30
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Purpose The present study aimed to identify patients’ experienced barriers and facilitators in implementing physical activity programs for patients with cancer.
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#2Benjamin O. Anderson (UAB: University of Alabama at Birmingham)H-Index: 10
#3Ron Balassanian (USF: University of South Florida)H-Index: 1
Last. William B. Farrar (University Of Tennessee System)H-Index: 1
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Prostate cancer represents a spectrum of disease that ranges from nonaggressive, slow-growing disease that may not re- quire treatment to aggressive, fast-growing disease that does. The NCCN Guidelines for Prostate Cancer Early Detection pro- vide a set of sequential recommendations detailing a screen- ing and evaluation strategy for maximizing the detection of prostate cancer that is potentially curable and that, if left un- detected, represents a risk to the patient. The guidelines were develo...
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#1Charlotte IJsbrandy (Radboud University Nijmegen)H-Index: 5
#2Petronella B. Ottevanger (Radboud University Nijmegen)H-Index: 30
Last. Rosella P.M.G. Hermens (Radboud University Nijmegen)H-Index: 32
view all 6 authors...
Abstract Background The purpose of this review was to assess the effectiveness of different strategies to implement physical activity during and after cancer treatment. Design We searched for studies containing strategies to implement physical activity in cancer care that meet the inclusion criteria of the Cochrane EPOC group. The primary outcome was physical activity uptake. We expressed the effectiveness of the strategies as the percentage of studies with improvement. Results Nine studies met ...
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#1Amarins J. Wijma (Vrije Universiteit Brussel)H-Index: 6
Last. C. Paul van Wilgen (Vrije Universiteit Brussel)H-Index: 19
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ABSTRACTPurpose: The literature review is aimed at examining and summarizing themes related to patient-centeredness identified in qualitative research from the perspectives of patients and physiotherapists. Following the review, a secondary aim was to synthesize the themes to construct a proposed conceptual framework for utilization within physiotherapy. Methods: A systematic search of qualitative studies was conducted including all articles up to 2015 September. Methodological quality was exami...
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#1Anne Reb (City of Hope National Medical Center)H-Index: 4
#2Nora Ruel (City of Hope National Medical Center)H-Index: 21
Last. Virginia Sun (City of Hope National Medical Center)H-Index: 29
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Abstract Purpose This study evaluates the feasibility and acceptability of a Self-Management Survivorship Care Planning (SM-SCP) intervention in colorectal and lung cancer survivors. Methods This is a single-group, pre- and post-mixed methods study of an advance practice nurse-driven survivorship care intervention that integrates a survivorship care plan with self-management skills coaching. Colorectal and lung cancer survivors with stage I-III disease were enrolled at 3–6 months after completin...
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#1Anne M. May (UU: Utrecht University)H-Index: 39
#2Marcel J C Bosch (UU: Utrecht University)H-Index: 1
Last. G. Ardine de Wit (UU: Utrecht University)H-Index: 32
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Objective Meta-analyses show that exercise interventions during cancer treatment reduce cancer-related fatigue. However, little is known about the cost-effectiveness of such interventions. Here we aim to assess the cost-effectiveness of the 18-week physical activity during cancer treatment (PACT) intervention for patients with breast and colon cancer. The PACT trial showed beneficial effects for fatigue and physical fitness. Design Cost-effectiveness analyses with a 9-month time horizon (18 week...
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#1Marita Sporstøl Fønhus (FHI: Norwegian Institute of Public Health)H-Index: 5
#2Therese Kristine Dalsbø (FHI: Norwegian Institute of Public Health)H-Index: 10
Last. Signe Flottorp (FHI: Norwegian Institute of Public Health)H-Index: 45
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BACKGROUND: Healthcare professionals are important contributors to healthcare quality and patient safety, but their performance does not always follow recommended clinical practice. There are many approaches to influencing practice among healthcare professionals. These approaches include audit and feedback, reminders, educational materials, educational outreach visits, educational meetings or conferences, use of local opinion leaders, financial incentives, and organisational interventions. In th...
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: This article describes one woman's experience with the shock and fear of a breast cancer diagnosis and the power of exercise in helping her cope, adjust, and regain her hope during treatment. Whenever appropriate, practitioners should encourage patients to be physically active to improve physical and psychosocial adjustment and outcomes.
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