A scoping review examining the integration of exercise services in clinical oncology settings.

Autor: Ezenwankwo EF; Centre for Health Through Physical Activity, Lifestyle and Sports (HPALS), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa. eznelo001@myuct.ac.za.; Cancer Research Initiative, Faculty of Health Sciences, University of Cape Town, Anzio Road, ObservatoryCape Town, 7925, South Africa. eznelo001@myuct.ac.za., Nnate DA; Department of Nursing and Community Health, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.; Countess of Chester Hospital NHS Foundation Trust, Health Park, Liverpool Road, Chester, CH2 1UL, UK., Usoro GD; Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria., Onyeso CP; Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria., Anieto IB; Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria., Ibeneme SC; Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria.; Department of Physiotherapy, Faculty of Health Sciences, School of Therapeuitc Studies, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, South Africa.; Department of Physiotherapy, Faculty of Health Sciences and Technology, King David University of Medical Sciences, Ebonyi State, Uburu, Nigeria., Albertus Y; Centre for Health Through Physical Activity, Lifestyle and Sports (HPALS), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa., Lambert VE; Centre for Health Through Physical Activity, Lifestyle and Sports (HPALS), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa., Ezeukwu AO; Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria., Abaraogu UO; Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria.; Department of Physiotherapy and Paramedicine, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK., Shamley D; Centre for Health Through Physical Activity, Lifestyle and Sports (HPALS), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.; Clinical Research Centre, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
Jazyk: angličtina
Zdroj: BMC health services research [BMC Health Serv Res] 2022 Feb 21; Vol. 22 (1), pp. 236. Date of Electronic Publication: 2022 Feb 21.
DOI: 10.1186/s12913-022-07598-y
Abstrakt: Background: Addressing questions surrounding the feasibility of embedding exercise service units in clinical oncology settings is imperative for developing a sustainable exercise-oncology clinical pathway. We examined available literature and offered practical recommendations to support evidence-based practice, policymaking, and further investigations.
Methods: Four thousand eight hundred sixty-three unique records identified in Embase, CINAHL, MEDLINE, Web of Science Core Collection, and ProQuest (Health and Medicine) were screened for studies that recruited cancer patients, assessed the co-location of exercise service and cancer treatment units, and reported findings on service implementation. Evidence from six studies providing data from over 30 programs was integrated using narrative synthesis.
Results: Service implementation was relatively modest across the included studies. Exercise services were delivered by physiotherapists, exercise physiologists, and kinesiologists and funded mainly through grants and private donations, with staff salaries accruing as the major expense. Service penetration, adoption, and acceptability were generally low. However, studies recorded high clinician/patient satisfaction. Major barriers to service integration were limited funding, lack of detailed implementation plan, and low organizational buy-in. Common reasons for non-utilization, missed sessions, and dropouts were lack of interest, unwellness, hospital readmission, disease progression, and adverse skeletal events.
Conclusion: Implementing exercise services in clinical oncology settings seems an effective approach for increasing access to exercise-based rehabilitation for individuals on cancer treatment. While this model appears feasible for patients/clinicians, efforts are required to optimize service integration both in the short and long term. Key priorities include seeking [local] actions to address issues relating to funding and organizational buy-in. Important considerations may include developing an implementation plan to guide the implementation process, expanding the patient core management team to include staff from the exercise rehabilitation unit, and exploring the role of patient feedback in increasing clinician participation (e.g., treating oncologists and nurses) in the referral process. Future research should consider effective strategies to promote patients' sense of self-efficacy and behavioral control and, further, the place of audit and feedback in improving exercise service delivery and overall service implementation.
(© 2022. The Author(s).)
Databáze: MEDLINE
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