Dennett Amy M, Peiris Casey L, Shields Nora, Morgan Delwyn, Taylor Nicholas F
School of Allied Health, La Trobe University and Allied Health Clinical Research Office, Eastern Health, VIC, Australia.
School of Allied Health, La Trobe University and Northern Health, VIC, Australia.
Asia Pac J Clin Oncol. 2017 Oct;13(5):e515-e527. doi: 10.1111/ajco.12642. Epub 2016 Dec 22.
Oncology rehabilitation improves outcomes for cancer survivors but little is known about program availability in Australia. The aims of this study were: to describe oncology rehabilitation programs in Australia: determine whether the exercise component of programs is consistent with guidelines: and to explore barriers and facilitators to program implementation.
A sequential, explanatory mixed-methods study was completed in two phases: (1) a survey of Australian oncology rehabilitation programs; and (2) purposively sampled follow-up semistructured interviews with senior clinicians working in oncology rehabilitation who were involved with exercise prescription.
Hospitals and/or cancer centers from 42 public hospital health networks (representing 163 hospitals) and 39 private hospitals were contacted to identify 31 oncology rehabilitation programs. All 31 surveys were returned (100% response rate). Programs were typically multidisciplinary, ran twice weekly, provided education and exercise and included self-management strategies. Exercise prescription and progression was patient centered and included a combination of resistance and aerobic training supplemented by balance, pelvic floor, and core stability exercises. Challenges to implementation included a lack of awareness of programs in the community and organizational barriers such as funding. Strong links with oncologists facilitated program referrals.
Despite evidence to support oncology rehabilitation, there are few programs in Australia and there are challenges that limit it becoming part of standard practice. Programs that exist are multidisciplinary with a focus on exercise with the majority of programs following a cardiac rehabilitation model of care.
肿瘤康复可改善癌症幸存者的预后，但对于澳大利亚的项目可及性了解甚少。本研究的目的是：描述澳大利亚的肿瘤康复项目；确定项目中的运动部分是否符合指南；并探讨项目实施的障碍和促进因素。
一项序贯性、解释性混合方法研究分两个阶段完成：（1）对澳大利亚肿瘤康复项目的调查；（2）对参与运动处方的肿瘤康复资深临床医生进行有目的抽样的后续半结构化访谈。
联系了来自42个公立医院健康网络（代表163家医院）和39家私立医院的医院和/或癌症中心，以确定31个肿瘤康复项目。所有31份调查问卷均已返回（回复率100%）。项目通常是多学科的，每周运行两次，提供教育和运动，并包括自我管理策略。运动处方和进展以患者为中心，包括阻力训练和有氧运动的组合，并辅以平衡、盆底和核心稳定性练习。实施的挑战包括社区对项目缺乏认识以及资金等组织障碍。与肿瘤学家的紧密联系促进了项目转诊。
尽管有证据支持肿瘤康复，但澳大利亚的项目很少，并且存在一些挑战限制其成为标准治疗的一部分。现有的项目是多学科的，以运动为重点，大多数项目遵循心脏康复护理模式。
