Csontos, Judit

Fitzsimmons, Deborah

Horton, Joanne

Jones, Mari

Love-Gould, Lisa

Tee, Anna

Watts, Tessa

Wilkinson, Wendy

Online Research @ Cardiff

The perception and operation of cancer rehabilitation services in South Wales from healthcare professionals’ perspective: a qualitative studyJudit Csontos, Professor Deborah Fitzsimmons, Dr Mari Jones, Wendy Wilkinson, Joanne Horton, Lisa Love-Gould, Anna Tee, Dr Tessa WattsIntroduction:Cancer rehabilitation can improve quality of life (Scott et al., 2013).However, accessing and providing cancer rehabilitation is difficult, becausethere is no consensus on the definition of cancer rehabilitation amongsthealth professionals (MacDonald, 2010). This can influence the perceptionand uptake of services (Robb & Davis, 2015). Moreover, in the UK healthcareprofessionals have reported lack of time, skills and confidence are barriers torehabilitation (Wells et al., 2014). However, the perception of cancerrehabilitation and how it works in different circumstances have not yet beenfully investigated.Aims:The qualitative study reported here is part of a three phase project: RealistEvaluation of Cancer Rehabilitation Services in South Wales (REEACaRS). Theaim is to explore how healthcare professionals perceive cancerrehabilitation, what it means to them and to investigate how services workin South Wales.Methodology:• A purposive sample of 20 healthcare professionals from two study siteswas recruited. Eligible participants had at least one year experience inoncology.• This study was approved by London South – East Research EthicsCommittee (17/LO/2123).• Written informed consent was sought from every participant before theinterviews.• Qualitative, audio recorded, semi-structured one-on-one interviewswere transcribed verbatim.• Thematic analysis was based on Braun and Clarke (2006).Preliminary findings:Four potential meanings of cancer rehabilitationhave been identified:• Cancer rehabilitation is goal focused and needdependent;• Rehabilitation is traditionally considered asaftercare;• Care and support from diagnosis until the endof life;• Cancer rehabilitation determined by itsbenefits.Having different meanings allocated to cancerrehabilitation might be the result of the lack ofconsensus on the definition of rehabilitation(MacDonald, 2010).Barriers to rehabilitation have been identified:• Medical model in healthcare;• Professional boundaries.These might originate from the diverse perceptionof cancer rehabilitationReferences:Braun, V. & Clarke, V. (2006). Qualitative Research in Psychology, 3(2), 77-101. MacDonald (2010). International Journal of Radiation Oncology, 77(5), 1604.Robb, K. & Davis, J. (2015). Eur J Cancer Care (Engl), 24(6), 601-604.Scott, D. A. et al. (2013). Cochrane Database of Systematic Reviews (3)Wells, M. et al. (2015). Eur J Cancer Care (Engl), 24(6), 873-883.Contact: Judit Csontos via e-mail: CsontosJK@Cardiff.ac.ukDate of preparation: 12/11/2018Cancer rehabilitation is goal focused and need dependentSome professionals believe that cancer rehabilitation should depend onpeople’s needs and it should be determined by individuals’ goals:“…establishing what the patients’ needs are and then supporting them to maximisetheir ability hm… to enable them to do what they want to be able to do.”(Professional_06 – Physiotherapist)Rehabilitation is traditionally considered as aftercareIn some settings rehabilitation is considered to start on treatmentcompletion. In acute settings where allied health professionals meet peopleduring chemo- or radiotherapy, they do not always consider their work asrehabilitation:“it’s not something that we’re really involved with hm… however, I think that’s hm…there is scope for change, so I’d like to think that you know dietitians could be moreinvolved in the rehabilitation side of it… In the acute setting we don’t really have theopportunity to hm… to see patients further down the line…” (Professional_07 –Dietitian)Care and support from diagnosis until the end of lifeSome professionals consider rehabilitation as therapy that involves everyaspect of care and support and should start from diagnosis until the end oflife:“I see cancer rehabilitation as encompassing hm… at any… at being utilised at any partof a… the patient’s cancer journey, so that could be right at the very onset, hm… atdiagnosis, hm… right through to end-of-life.” (Professional_12 – OT)Cancer rehabilitation determined by its benefitsFor a professional rehabilitation means seeing the improvement in aperson’s quality of life and everyday activities:“…they’ve improved and they were able to go home with perhaps a rollator frame. Soyeah, it’s really great to see how you can impact on somebodies life and quality oflife.” (Professional_10 – Therapy technician)Medical model in healthcare as a barrier to cancer rehabilitationCancer rehabilitation is not always considered important by medicalprofessionals, even though rehabilitation makes a significant contribution toalleviating side effects and long-term consequences. Misconceptions canhave an impact on referral and service promotion:“I think unfortunately we have quite a… a quiet reputation, not everybody knowswhat we do as a Therapies Team let alone then the breakdown of physio, OT, speechand language.…but they still unfortunately I think even this… to this day a lot of doctors don’trealise what we’re here for and what we can do for the patients.” (Professional_05 –Therapy technician)Professional boundaries as a barrier to cancer rehabilitationCertain allied health professional groups reported that there areprofessional boundaries between specialities that potentially can have aneffect on the provision of care:“…if a physio here identifies somebody needs a second stair rail, why refer them to uswhen you… they’re quite capable of filling in the form to do it. Hm… it’s better theperson who knows that patient best. Hm… they don’t need to come our way just for astair rail, but culturally that’s what’s so that’s happened…” (Professional_12 – OT)Conclusion:The preliminary findings of this ongoing study indicate that there is no consensus amongst allied health professionals on the meaning of cancerrehabilitation. This can have an effect on how other members of the multidisciplinary team and people affected by cancer perceive the services, which canhave an impact on referral numbers and the utilisation of rehabilitation services.

The perception and operation of cancer rehabilitation services in South Wales from healthcare professionals' perspective: a qualitative study

https://orca.cardiff.ac.uk/id/eprint/122272/1/Poster%20v3%20-%20The%20perception%20and%20operation%20of%20cancer%20rehabilitation%20services.pdf

The perception and operation of cancer rehabilitation services in South Wales from healthcare professionals' perspective: a qualitative study

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