| Popis: |
Background Multi-disciplinary, exercise-based, oncology rehabilitation improves outcomes for cancer survivors. However, most programs currently exist in hospital settings and there is limited access to rehabilitation in the community. Community-based programs may improve access and outcomes but the feasibility of implementing multi-disciplinary rehabilitation in this setting is unknown. Aim To assess the feasibility of implementing an innovative, multi-disciplinary, multi-site exercise-based oncology rehabilitation program in the community. Method A prospective feasibility study focussed on demand, implementation, acceptability, and limited efficacy was conducted. The Program for Oncology Wellness and Exercise Rehabilitation (POWER) comprised twice-weekly group exercise, fortnightly education and individual counselling for cancer survivors over 12-weeks. Limited efficacy testing was completed by calculating mean differences (MD) and 95% confidence intervals (CI) for outcomes including the Self-Efficacy to Manage Chronic Disease Scale, EORTC-QLQ30, Brief Fatigue Inventory, 6-minute walk test (6MWT) and 5 times sit-to-stand test (5STS). Results Over 10 months, 65 referrals were received. Twenty-four participants [mean age 62 (SD 12) years, median 9 (range 2 to 120) months post-cancer diagnosis] completed the program. Overall, 73% of scheduled exercise sessions were attended. Participants improved physical function (6MWT MD 98.5m, 95%CI 64m to 134m, 5STS MD -4.5s, 95%CI -7.8s to -1.1s), self-efficacy (MD 1.1 points, 95%CI 0.2 to 2.4) and fatigue (MD -1.1 points, 95%CI -2.2 to 0.0). No adverse events were reported. Challenges faced in this setting included funding sustainability and cost. Enabling factors included in-kind support from the organisation and convenience of location. Conclusion Community-based oncology rehabilitation programs are safe and feasible and may facilitate ongoing positive behaviour change and self-management in cancer survivors beyond hospital- based rehabilitation. |
