Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.
The University Hospitals' Centre for Health Research (UCSF), Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
BMJ Open. 2020 Jul 28;10(7):e037280. doi: 10.1136/bmjopen-2020-037280.
Breast cancer survivors experience a wide spectrum of physical sequelae from cancer treatment. National and international guidelines recommend that rehabilitation is offered from the point of diagnosis. However, there is a lack of data on the translation of these recommendations into clinical care. The objective of this study was to explore the experiences of breast cancer survivors, rehabilitation professionals and breast surgeons on current rehabilitation services including preferences for care delivery, specific ways to promote early detection and timely management of upper body issues and attitudes towards self-managed surveillance and rehabilitation.
Qualitative focus groups. Breast cancer survivors completed a questionnaire about rehabilitation services received and experience of upper body issues. These quantitative data were collected to provide context for the qualitative data and increase transferability. Transcripts were analysed using content analysis.
Five geographically distinct health authorities in British Columbia, Canada.
Eleven focus groups were conducted with 35 breast cancer survivors, 29 rehabilitation professionals and 5 breast surgeons.
Three categories captured participants' concern and wish for improved care: (1) ; (2) and (3) . All breast cancer survivors reported chronic upper body issues (mean 4.5 unique issues). Breast cancer survivors expressed worry and uncertainty in their solo management of the rehabilitation. The current services were reported to not enable early detection and timely management. Suggestions included reorganising the timing of patient education and improving the quality of and access to rehabilitation services by elevating the knowledge among healthcare professionals and providing multimodal self-management resources.
The results revealed a gap between oncology guidelines and the current clinical reality. The rehabilitation services were reported in need of revamping to increase equity of care. Multiple upper body issues were reported by many breast cancer survivors.
乳腺癌幸存者在癌症治疗后会经历广泛的身体后遗症。国家和国际指南建议从诊断时就提供康复服务。然而，这些建议如何转化为临床护理，相关数据却十分缺乏。本研究的目的是探讨乳腺癌幸存者、康复专业人员和乳腺外科医生对当前康复服务的体验，包括对护理提供方式的偏好、促进早期发现和及时管理上半身问题的具体方法，以及对自我管理监测和康复的态度。
定性焦点小组。乳腺癌幸存者完成了一份关于接受康复服务和上半身问题体验的问卷。这些定量数据是为了提供定性数据的背景信息并增加可转移性而收集的。使用内容分析法分析转录本。
加拿大不列颠哥伦比亚省五个地理位置不同的卫生当局。
11 个焦点小组共有 35 名乳腺癌幸存者、29 名康复专业人员和 5 名乳腺外科医生参加。
三个类别捕捉到了参与者对改善护理的关注和愿望：（1）；（2）；（3）。所有乳腺癌幸存者都报告了慢性上半身问题（平均 4.5 个独特问题）。乳腺癌幸存者在独自管理康复方面表示担忧和不确定。目前的服务据报道无法实现早期发现和及时管理。建议包括重新安排患者教育的时间，通过提高医疗保健专业人员的知识并提供多模式自我管理资源，改善康复服务的质量和可及性。
结果显示肿瘤学指南与当前临床现实之间存在差距。康复服务需要进行改革，以增加护理的公平性。许多乳腺癌幸存者报告了多种上半身问题。
