在当前实践中为癌症患者实施身体活动计划：患者的体验障碍和促进因素。
Implementing physical activity programs for patients with cancer in current practice: patients' experienced barriers and facilitators.
机构信息
Radboud Institute for Health Science (RIHS), Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud University Medical Centre Nijmegen, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
Radboud Institute for Health Science (RIHS), Department of Medical Oncology, Radboud University Medical Centre Nijmegen, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
出版信息
J Cancer Surviv. 2019 Oct;13(5):703-712. doi: 10.1007/s11764-019-00789-3. Epub 2019 Jul 25.
PURPOSE
The present study aimed to identify patients' experienced barriers and facilitators in implementing physical activity programs for patients with cancer.
METHODS
We interviewed 34 patients in focus-group-interviews from three different hospital-types. We included patients with cancer who were either receiving curative treatment or had recently completed it. Barriers and facilitators were explored in six domains: (1) physical activity programs, (2) patients, (3) healthcare professionals (HCPs), (4) social setting, (5) organization, and (6) law and governance.
RESULTS
We found 12 barriers and 1 facilitator that affect the implementation of physical activity programs. In the domain of physical activity programs, the barrier was physical activity programs not being tailored to the patient's needs. In the domain of patients, lacking responsibility for one's own health was a barrier. Knowledge and skills for physical activity programs and non-commitment of HCPs impeded implementation in the domain of HCPs. Barriers in the domain of organization included inconvenient place, time of day, and point in the health treatment schedule for offering the physical activity programs, inadequate capacity, inaccessibility of contact persons, lack of information about physical activity programs, non-involvement of the general practitioner in the cancer care process, and poor communication between secondary and primary HCPs. Insufficient insurance-coverage of physical activity programs was a barrier in the domain of law and governance. In the domain of physical activity programs, contact with peers facilitated implementation. We found no barriers or facilitators at the social setting.
CONCLUSIONS
Factors affecting the implementation of physical activity programs occurred in various domains. Most of the barriers occurred in the domain of organization.
IMPLICATIONS FOR CANCER SURVIVORS
An implementation strategy that deals with the barriers might improve the implementation of physical activity programs and quality of life of cancer survivors.
目的
本研究旨在确定患者在实施癌症患者体育活动计划方面所面临的障碍和促进因素。
方法
我们对来自三种不同医院类型的 34 名患者进行了焦点小组访谈。我们纳入了正在接受或刚刚完成治愈性治疗的癌症患者。在六个领域探讨了障碍和促进因素：（1）体育活动计划，（2）患者，（3）医疗保健专业人员（HCP），（4）社会环境，（5）组织，和（6）法律和治理。
结果
我们发现了 12 个障碍和 1 个促进因素，这些因素影响了体育活动计划的实施。在体育活动计划领域，障碍是体育活动计划没有根据患者的需求进行调整。在患者领域，缺乏对自身健康的责任感是一个障碍。在 HCP 领域，缺乏体育活动计划的知识和技能以及 HCP 的不承诺阻碍了实施。组织领域的障碍包括提供体育活动计划的地点、时间和治疗时间表上的时间不方便、能力不足、联系人难以接触、缺乏关于体育活动计划的信息、全科医生不参与癌症治疗过程以及二级和初级 HCP 之间沟通不畅。体育活动计划的保险覆盖不足是法律和治理领域的障碍。在体育活动计划领域，与同行的接触促进了实施。我们在社会环境领域没有发现障碍或促进因素。
结论
影响体育活动计划实施的因素发生在各个领域。大多数障碍发生在组织领域。
对癌症幸存者的影响
处理障碍的实施策略可能会提高体育活动计划的实施和癌症幸存者的生活质量。
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