Factors influencing utilization of cancer rehabilitation services among older breast cancer survivors in the USA: a qualitative study

Brick, Rachelle; Lyons, Kathleen Doyle; Bender, Catherine; Eilers, Rachel; Ferguson, Robert J.; Pergolotti, Mackenzi; Toto, Pamela; Skidmore, Elizabeth R.; Leland, Natalie E.

doi:10.1007/s00520-021-06678-9

Cited by 14 publications

(16 citation statements)

References 34 publications

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“…Despite research and recommendations supporting rehabilitation and exercise during and after BC treatment, less than 20% of individuals receive this essential survivorship care [22]. National and global barriers include a dearth of specialized oncology physical therapists and community-based specialty clinics, as well as a lack of established collaboration among oncology healthcare providers and rehabilitation providers.…”

Section: Introductionmentioning

confidence: 99%

Racial disparity in breast cancer survivorship: themes from a series of four national healthcare provider live virtual forums

et al. 2023

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Purpose Significant disparity exists in the diagnosis, treatment, and survivorship outcomes among Black breast cancer (BC) survivors. Black BC survivors have more significant survivorship issues and a greater burden of illness than White counterparts. Barriers to rehabilitation exist for all BC survivors but are magnified in Black BC survivors. The purpose of this qualitative research was to document patient, clinician, and researchers’ perceptions surrounding contributing factors, lived experiences, and potential solutions to racial disparity in BC survivorship. Methods A narrative approach was utilized to identify themes from a series of four virtual healthcare provider forums that explored lived personal and professional experiences, issues, and potential solutions surrounding racial disparity in BC survivorship. Forums included perspectives of patients, healthcare providers, researchers, and stakeholders in the BC field. An independent thematic analysis was performed by the investigators, all of whom have emic perspectives with respect to race and/or BC. Results Three main themes were identified related to racial disparity in BC survivorship: (1) societal and cultural contributing factors, (2) contribution of healthcare providers and systems, and (3) models of care and research considerations. Conclusions The findings provide compelling documentation of lived personal and professional experiences of racial disparity in BC survivorship. Potential solutions exist and must be enacted immediately to ensure equitable survivorship outcomes for Black individuals following a BC diagnosis. Implications for Cancer Survivors Increased awareness related to racial disparity in BC survivorship among survivors, healthcare providers, and researchers will contribute to health equity and improved outcomes for Black individuals.

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Section: Introductionmentioning

confidence: 99%

Racial disparity in breast cancer survivorship: themes from a series of four national healthcare provider live virtual forums

et al. 2023

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“…Despite availability12 and survivors' desire to receive services for cancer-related disability,13 few older individuals surviving breast cancer access, or engage in, cancer rehabilitation interventions. A recent thematic analysis found that access to rehabilitation services in this population may be affected by factors such as provider interactions, social support, and emerging awareness of disability 14. However, findings from this work did not identify how various elements of intervention or service delivery influence utilization of services 14…”

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confidence: 76%

Preferences on Delivery of Cancer Rehabilitation Services for Cancer-Related Disability Among Older Individuals Surviving Breast Cancer: A Qualitative Study

Brick

Bender

Eilers

et al. 2023

Rehabilitation Oncology

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Background: Older individuals surviving breast cancer often encounter cancer-related disability as a short-term or long-term effect of cancer and related treatment. Cancer rehabilitation interventions have the potential to prevent, mitigate, or remediate cancer-related disability. However, use of these services remains limited. Understanding the priorities and perspectives of older individuals surviving breast cancer is key to developing effective and implementable cancer rehabilitation interventions. This qualitative descriptive study examined individuals' preferred and valued methods of cancer rehabilitation intervention delivery. Methods: Using a qualitative descriptive design, older individuals surviving breast cancer (n = 14) completed a single, telephone-based, semistructured interview. Interviews explored survivors' preferences for cancer rehabilitation service delivery. Interview transcriptions were thematically analyzed. Open codes were inductively generated and reviewed for agreement by an independent reviewer. The codes were deductively organized. Differences were resolved through consensus meetings. Results: Findings revealed preferred intervention delivery characteristics for intervention setting, mode of delivery, format, and timing. Participants predominantly preferred interventions delivered in community-based settings, with both in-person and remote components. Participants also appeared to value one-on-one interventions and those delivered posttreatment. Survivors' overarching preferences were based on desire for patient-centric care, one-on-one therapist time, complex medical schedules, and financial concerns. Conclusion: Study findings provide guidance on the modification of existing and creation of new cancer rehabilitation interventions addressing cancer-related disability in older individuals surviving breast cancer. Adoption of stakeholder-driven intervention delivery characteristics may improve value and acceptability of interventions. Future intervention research should incorporate and test these characteristics to ensure their effectiveness in real-world settings.

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“…These facts highlight the need to address the constraints and barriers experienced by patients and healthcare services. One of the reasons proposed to explain this low level of access to physiotherapy is the lack of knowledge among health professionals of the correct use of physiotherapy in functional rehabilitation [25]. Some studies report that only in a quarter of the cases, functional impairments are detected by oncologist and referral to rehabilitation services [26].…”

Section: Discussionmentioning

confidence: 99%

Social inequalities in the use of physiotherapy in women diagnosed with breast cancer in Barcelona: DAMA cohort

Cogollos-de-la-Peña,

Domínguez-Navarro,

Álvarez-Vargas

et al. 2023

Preprint

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Purpose This study aimed to analyze social inequalities in the use and access of physiotherapy service and its clinical and socio-economic determinants in women diagnosed with breast cancer in the hospital network of Barcelona.Methods Data from 2335 women belonging to the mixed (prospective and retrospective) DAMA Cohort were analyzed, including demographic, socio-economic, clinical and breast cancer-treatment outcomes. To determine the influence of such variables on access to physiotherapy, different Poisson regression models with robust variance (obtaining Prevalence Ratios and confidence intervals) were estimated.Results Although when experiencing different chronic and acute symptoms, only between 20 and 35% of women visited physiotherapist. Two out of 3 women reported to have received insufficient information about medical care and rehabilitation. Age of women, job occupation, education level, having a mutual or private insurance; as well as outcomes related to breast cancer, appear to be factors influencing the access to physiotherapy.Conclusions Social and economic inequalities exist on the access to physiotherapy by women diagnosed with breast cancer, which is generally low, and may clearly impacts on their functional recovery. Promoting strategies to reduce social bias, as well as improve communication and patient information regarding physiotherapy may be of interest for a better health care in breast cancer diagnosed women.

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Factors influencing utilization of cancer rehabilitation services among older breast cancer survivors in the USA: a qualitative study

Cited by 14 publications

References 34 publications

Racial disparity in breast cancer survivorship: themes from a series of four national healthcare provider live virtual forums

Racial disparity in breast cancer survivorship: themes from a series of four national healthcare provider live virtual forums

Preferences on Delivery of Cancer Rehabilitation Services for Cancer-Related Disability Among Older Individuals Surviving Breast Cancer: A Qualitative Study

Social inequalities in the use of physiotherapy in women diagnosed with breast cancer in Barcelona: DAMA cohort

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