University of Pittsburgh, Department of Occupational Therapy, Bridgeside Point I, 100 Technology Drive, Pittsburgh, PA 15219, USA.
University of Pittsburgh, School of Nursing, 415 Victoria Building, 3500 Victoria Street, Pittsburgh, PA 15261, USA.
J Geriatr Oncol. 2022 Sep;13(7):1031-1037. doi: 10.1016/j.jgo.2022.06.007. Epub 2022 Jun 22.
Older breast cancer survivors have difficulty accessing rehabilitation interventions addressing activity limitations. Stakeholder input may improve accessibility of interventions. We sought expert consensus on intervention content and delivery features (e.g., where, mode, duration) to inform development of more accessible interventions for this population.
We conducted a modified Delphi process with patient, clinical, administrative, and research experts. In Round 1, experts evaluated content and delivery features according to domains of feasibility and prioritization. In Round 2, panelists were asked to re-rank or confer agreement of content and delivery features that met Round 1 consensus. Ranking was based on median score. Consensus was defined as a percentage of panelists that ranked an option within one unit of the median. For nominal data, consensus was defined as percent agreement.
Panelists (n = 20) prioritized physical activity strategies (Median Rank: 2; Consensus: 85%) and adaptive skills training (3; 65%). Panelists also prioritized delivery through outpatient services (1; 100%), post-treatment (1; 100%), combination mode of delivery (100%), duration of three months or less (100%) and occurring one to two days per week (100%).
Cancer rehabilitation interventions should be designed with input from stakeholders. The stakeholder intervention priorities identified in this study (e.g., content, setting, and mode) may improve relevance and accessibility of future cancer rehabilitation interventions. Interventions delivered in outpatient clinics and post-treatment using virtual and in-person visits may improve accessibility. Future research should examine the effectiveness and implementation of these intervention characteristics.
老年乳腺癌幸存者在获得针对活动受限的康复干预措施方面存在困难。利益相关者的意见可能会提高干预措施的可及性。我们寻求专家对干预内容和交付特征（例如，地点、模式、持续时间）的共识，为这一人群开发更易获得的干预措施提供信息。
我们采用改良 Delphi 法，邀请患者、临床、行政和研究专家参与。在第 1 轮中，专家根据可行性和优先级领域评估内容和交付特征。在第 2 轮中，要求小组成员重新对满足第 1 轮共识的内容和交付特征进行排名或达成一致。排名基于中位数得分。共识定义为将选项排名在中位数一个单位内的专家百分比。对于名义数据，共识定义为百分比一致。
小组成员（n=20）优先考虑了身体活动策略（中位数排名：2；共识：85%）和适应技能培训（3；65%）。小组成员还优先考虑通过门诊服务（1；100%）、治疗后（1；100%）、组合交付模式（100%）、三个月或更短时间（100%）和每周一到两天（100%）进行交付。
癌症康复干预措施的设计应考虑利益相关者的意见。本研究中确定的利益相关者干预重点（例如，内容、环境和模式）可能会提高未来癌症康复干预措施的相关性和可及性。在门诊诊所和治疗后使用虚拟和面对面访问进行交付可能会提高可及性。未来的研究应检验这些干预特征的有效性和实施情况。
