Institut Gustave Roussy, Université Paris-Saclay, Inserm, Biomarqueurs Prédictifs et Nouvelles Stratégies Thérapeutiques en Oncologie, Villejuif, France.
Hôpital Saint-Camille, Unité de Soins Médicaux en Oncologie (USMO), Bry-sur-Marne, France.
Eur J Cancer Care (Engl). 2021 Mar;30(2):e13370. doi: 10.1111/ecc.13370. Epub 2020 Nov 15.
Cancer-related fatigue (CRF) is among the most common and distressing side effects of cancer treatment. Different types of interventions, including physical activity (PA), psychosocial and mind-body interventions, have been shown to reduce CRF. We aimed to explore HCPs' practices and barriers to refer patients towards interventions to reduce CRF.
We performed a qualitative study using key informant interviews among a sample of 20 HCPs including medical, surgical and radiation oncologists, pain specialists, nurses, psychologists, psychiatrists and physiotherapists recruited from breast, prostate and colorectal cancer disease groups from a comprehensive cancer centre.
Most interviewees reported not to address CRF spontaneously during consultations. When the topic of CRF was brought up by patients, all interviewees acknowledged to recommend PA, whereas few would recommend psychosocial or mind-body interventions. Barriers to recommend interventions to manage CRF included: lack of knowledge about CRF and its treatment, lack of time and complexity of the referral due to their accessibility and cost.
In a diverse sample of HCPs, most acknowledged not to address CRF proactively with their patients, but identified several actionable barriers. Specific training on screening and management of CRF and improving the referral network dedicated to interventions need to be implemented.
癌症相关疲劳(CRF)是癌症治疗中最常见和最令人痛苦的副作用之一。已经证明,包括身体活动(PA)、心理社会和身心干预在内的不同类型的干预措施可以减轻 CRF。我们旨在探讨 HCP 将患者转介至干预措施以减轻 CRF 的实践和障碍。
我们对来自综合癌症中心的乳腺癌、前列腺癌和结直肠癌疾病组的 20 名 HCP 进行了一项定性研究,采用关键知情人访谈的方法进行研究。HCP 包括医学、外科和放射肿瘤学家、疼痛专家、护士、心理学家、精神科医生和物理治疗师。
大多数受访者报告说,在咨询中不会自发地解决 CRF 问题。当患者提出 CRF 问题时,所有受访者都承认会推荐 PA,而很少会推荐心理社会或身心干预。推荐干预措施来管理 CRF 的障碍包括:缺乏对 CRF 及其治疗的了解,由于可及性和成本,缺乏时间和转诊的复杂性。
在多元化的 HCP 样本中,大多数人承认没有主动与患者讨论 CRF,但确定了一些可采取行动的障碍。需要实施专门针对 CRF 的筛查和管理以及改善专门针对干预措施的转诊网络的培训。