Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, United Kingdom.
Academy of Sport and Physical Activity, Sheffield Hallam University, Sheffield, United Kingdom.
J Phys Act Health. 2024 Aug 16;21(10):1080-1091. doi: 10.1123/jpah.2023-0622. Print 2024 Oct 1.
Approximately 3 million people in the United Kingdom are currently living with or beyond cancer. People undergoing treatment for cancer are at risk of complications following treatment. Increasing evidence supports the role of rehabilitation (including prehabilitation) in enhancing psychological and physical well-being in patients with cancer and improving outcomes. Active Together is an evidence-based, multimodal rehabilitation service for patients with cancer, providing support to help patients prepare for and recover from treatment. This paper presents the evaluation protocol for the Active Together service, aiming to determine its impact on patient-reported outcomes and clinical endpoints, as well as understand processes and mechanisms that influence its delivery and outcomes.
This evaluation comprises an outcome and process evaluation, with service implementation data integrated into the analysis of outcome measures. The outcome evaluation will assess changes in outcomes of patients that attend the service and compare health care resource use against historical data. The process evaluation will use performance indicators, semistructured interviews, and focus groups to explore mechanisms of action and contextual factors influencing delivery and outcomes. Integrating psychological change mechanisms with outcome data might help to clarify complex causal pathways within the service.
Evidence to support the role of multimodal rehabilitation before, during, and after cancer treatment is increasing. The translation of that evidence into practice is less advanced. Findings from this evaluation will contribute to our understanding of the real-world impact of cancer rehabilitation and strengthen the case for widespread adoption of rehabilitation into routine care for people with cancer.
目前，英国约有 300 万人患有癌症或已从癌症中康复。正在接受癌症治疗的患者在治疗后有出现并发症的风险。越来越多的证据表明，康复（包括预康复）在提高癌症患者的心理和身体健康水平以及改善治疗结果方面发挥着作用。Active Together 是一种基于证据的多模式康复服务，为癌症患者提供支持，帮助他们为治疗做好准备并从治疗中恢复。本文介绍了 Active Together 服务的评估方案，旨在确定其对患者报告的结果和临床终点的影响，以及了解影响其交付和结果的过程和机制。
该评估包括结果和过程评估，将服务实施数据纳入结果测量的分析中。结果评估将评估参加服务的患者的结果变化，并将医疗保健资源的使用与历史数据进行比较。过程评估将使用绩效指标、半结构化访谈和焦点小组来探讨影响服务交付和结果的作用机制和背景因素。将心理变化机制与结果数据相结合，可能有助于阐明服务中复杂的因果关系。
支持在癌症治疗之前、期间和之后进行多模式康复的证据正在增加。将该证据转化为实践的工作进展较少。这项评估的结果将有助于我们了解癌症康复的实际影响，并为在癌症患者的常规护理中广泛采用康复措施提供依据。
