Lifestyle advice to cancer survivors: a qualitative study on the perspectives of health professionals

Abstract

ObjectivesAdoption of healthy lifestyle behaviours has shown promising effectiveness in reducing the high morbidity burden of cancer survivors. Health professionals (HPs) are well suited to provide lifestyle advice but few survivors report receiving guidance from them. This study aimed to explore HPs’ perspective of lifestyle advice (on healthy eating, physical activity, smoking, and alcohol) for cancer survivors.DesignIn-depth semistructured qualitative interviews were conducted by telephone or face to face. Data were analysed using qualitative content analysis.Setting and participantsTwenty-one UK HPs working in secondary care with breast, prostate or colorectal cancer survivors were interviewed.ResultsThe overarching theme was that HPs’ desire to provide lifestyle advice was not necessarily matched by knowledge and action. Three main themes were identified: (1) survivorship-centred barriers to provision, (2) HP-centred barriers to provision, and (3) optimal delivery of lifestyle advice. Results suggested that HPs’ perceptions of survivors’ current status of practising health behaviours, their perceived socioeconomic barriers and ability to practise health behaviours, and HPs’ fear for potential loss of connection with the patient influenced provision of lifestyle advice. Further factors included HPs’ knowledge of healthy lifestyle guidelines, feeling that they were not the ‘right person’ to provide advice, and lack of time and resources. HPs stressed that the optimal delivery of lifestyle advice should (1) be tailored to the individual and delivered throughout the cancer journey, (2) be focused on small and achievable changes framed as part of their treatment regimen and (3) be cost-effective for wide-scale implementation.ConclusionsIncorporation of the identified barriers when developing HP training programmes and lifestyle interventions could increase the probability of successful behavioural change, and thus improve outcomes for cancer survivors.

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

“…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.…”

The European Cancer Patient Coalition and its central role in connecting stakeholders to advance patient‐centric solutions in the mission on cancer

“…Currently, various unacceptable inequalities exist across Europe regarding cancer care and rehabilitation and reintegration of people with cancer and cancer survivors in social and professional life. Such inequalities include unequal access to curative cancer treatments; extreme variability and accessibility in cancer screening services; lack of patient‐accessible, accurate, and up‐to‐date information; fragmented or missing cancer rehabilitation services; poor governance; major organisational, structural, and fiscal deficits in health planning; and the lack of a citizen‐focused European cancer survivorship plan [addressed in the ECPC position paper ‘Challenging the Europe of disparities in cancer’ (European Cancer Patient Coalition, )] (Table ; Albreht et al ., ; De Angelis et al ., ; European Cancer Patient Coalition, , ,, ,; European Commission, ; European Society for Medical Oncology, ; Kandolf Sekulovic et al ., ; Koutoukidis et al ., ; Luengo‐Fernandez et al ., ; Mehnert et al ., ; Peiró Pérez et al ., ).…”

“…aims to evaluate the impact of a mobile phone-based, remote-monitoring, symptom-management intervention (the Advanced Symptom Management System, ASyMS) on the delivery of care to people diagnosed with nonmetastatic breast, colorectal or haematologic cancer during chemotherapy and for 1 year after the end of treatment. addressed in the ECPC position paper 'Challenging the Europe of disparities in cancer' (European Cancer Patient Coalition, 2015)](Table 4;Albreht et al, 2017;De Angelis et al, 2014; European Cancer Patient Coalition, 2015, 2017a,b, 2018a European Commission, 2018; European Society for Medical Oncology, 2017;Kandolf Sekulovic et al, 2017;Koutoukidis et al, 2018;Luengo-Fernandez et al, 2013; Mehnert et al, 2013; Peir o P erez et al, 2017).The ECPC has persuaded the participating EU Member States to recognise the need for a Policy Paper on inequalities to complement the CanCon Guide. The ECPC co-authored the CanCon's Policy Paper 'Tackling social inequalities in cancer prevention and control for the European population' (Peir o P erez et al,…”

Therapeutic radiographers’ delivery of health behaviour change advice to those living with and beyond cancer: a qualitative study

“…12 Despite this, research to date among both HCPs and those LWBC consistently shows that few oncology HCPs offer guidance to oncology patients on healthy lifestyle behaviours. [13][14][15][16][17][18][19][20][21] Reported barriers among HCPs in providing health behaviour advice for those Strengths and limitations of this study ► This study provides an insight in therapeutic radiographers' views on all key modifiable health behaviours for those living with and beyond cancer. ► The participants worked in different radiotherapy departments, offering insight into the practices among therapeutic radiographers in the delivery of healthy behaviour advice from a wide range of hospitals.…”

“…Open access LWBC, include believing that giving advice was not part of their role, lack of time with patients, lack of referral programmes, lack of resources such as education leaflets for those LWBC and lack of knowledge regarding guidelines and research findings. [16][17][18][19][20][21] A recent qualitative study with 21 oncology HCPs identified that advice on health behaviours provided to those LWBC focussed on general health and controlling side effects, with few HCPs advising on health behaviours in the context of improving survival outcomes. 20 While these studies provide useful insight into the practices and barriers among oncology HCPs the participants within these studies were primarily oncologists and nurses and focussed on the provision of physical activity and weight management advice.…”