Cardiff University, Cardiff, UK.
Swansea University, Swansea, UK.
BMJ Open. 2019 Apr 23;9(4):e025953. doi: 10.1136/bmjopen-2018-025953.
Long-term and late effects of cancer treatments can cause functional limitations and reduce quality of life. Cancer rehabilitation services, which can comprise physical exercise, psychological support and educational interventions depending on the individual's needs, have been found to have a positive effect on health-related quality of life worldwide. However, accessibility or the lack of awareness on available help can act as barriers and influence the uptake of services, resulting in people having unmet rehabilitation needs. In Wales, UK, 41% of people, who have had health and social care needs resulting from cancer and its treatments, reported that they did not receive care when needed. The reason for this lack of support has not yet been fully investigated. The aim of this study is to investigate the conditions in which cancer rehabilitation services work and their underpinning mechanisms in South Wales, UK, specifically addressing barriers, facilitators and costs.
Realist evaluation, which explains for whom a service works in what circumstances and how through context-mechanism-outcome pattern conjunctions, will be used in three phases to investigate the conditions in which cancer rehabilitation services work and their underpinning mechanisms. Phase 1 will be secondary analysis of a cancer rehabilitation database from a local Health Board to give context to who are accessing rehabilitation. Phase 2 will be thematic analysis of face-to-face, semistructured rehabilitation participant (n=20) and healthcare professional (n=20) interviews to explore the mechanisms of how cancer rehabilitation works. Phase 3 will be two case studies and cost-consequences analysis of cancer rehabilitation services.
This study received favourable ethical opinion from London South-East Research Ethics Committee (17/LO/2123) in December 2017. This project is part of the author's PhD thesis and it is expected that the findings will be disseminated in academic journals and at local and international conferences.
癌症治疗的长期和晚期影响会导致功能受限，降低生活质量。癌症康复服务可以包括根据个人需求进行的体育锻炼、心理支持和教育干预，已被发现对全球的健康相关生活质量有积极影响。然而，可及性或对现有帮助的缺乏认识可能成为障碍，并影响服务的利用，导致人们的康复需求未得到满足。在英国威尔士，41%的人因癌症及其治疗而产生了健康和社会护理需求，但他们报告说在需要时没有得到护理。造成这种支持缺失的原因尚未得到充分调查。本研究的目的是调查南威尔士英国癌症康复服务的运作情况及其潜在机制，特别是解决障碍、促进因素和成本问题。
真实主义评价将用于三个阶段，以调查癌症康复服务的运作情况及其潜在机制，解释服务在何种情况下为谁服务以及如何服务，通过背景-机制-结果模式的结合。第 1 阶段将对当地卫生局的癌症康复数据库进行二次分析，以了解谁在接受康复治疗。第 2 阶段将对 20 名康复参与者和 20 名医疗保健专业人员的面对面半结构化访谈进行主题分析，以探讨癌症康复如何发挥作用的机制。第 3 阶段将进行两项案例研究和癌症康复服务的成本-后果分析。
本研究于 2017 年 12 月获得伦敦东南研究伦理委员会（17/LO/2123）的有利伦理意见。该项目是作者博士论文的一部分，预计研究结果将在学术期刊和地方及国际会议上发表。
