Rachelle Brick1, Kathleen Doyle Lyons2, Catherine Bender3, Rachel Eilers4, Robert Ferguson5, Mackenzi Pergolotti6, Pamela Toto4, Elizabeth Skidmore4, Natalie E Leland4. 1. Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA, USA. rsb50@pitt.edu. 2. Department of Occupational Therapy, Massachusetts General Hospital Institute of Health Professions, Boston, MA, USA. 3. School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA. 4. Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA, USA. 5. Division of Hematology/Oncology, Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA. 6. ReVital Cancer Rehabilitation, Select Medical, Mechanicsburg, PA, USA.
Abstract
PURPOSE: Many older breast cancer survivors experience long-term disability due to cancer and cancer-related treatments. However, less than 20% of older breast cancer survivors utilize cancer rehabilitation services to address cancer-related disability. Further understanding of survivor experiences may reveal strategies to improve uptake cancer rehabilitation services in the USA. METHODS: Older breast cancer survivors were recruited from university-based registries, previous breast cancer research studies at our institution, community support groups, and geriatric oncology clinics. Participants completed a brief online survey to capture demographic and clinical characteristics. Semi-structured telephone-based interviews were recorded, transcribed, and thematically analyzed. Interviews facilitated conversation about access to rehabilitation and indications for cancer rehabilitation. RESULTS: Participants (n = 14) were, on average, 71 years old, primarily White, and an average of 36.5 months post-diagnosis. Five participants had formally received rehabilitation for a cancer-related concern. Participants described seven factors that influenced utilization of cancer rehabilitation services: (1) emerging awareness of disability; (2) coping styles; (3) comparison of cancer experience with others; (4) provider interaction; (5) perceptions of cancer diagnosis; (6) social support; and (7) cost of rehabilitation. CONCLUSIONS: Older breast cancer survivors consider multiple factors when determining utilization of cancer rehabilitation services. Development of shared decision-making tools addressing the seven described factors may enhance communication and referral to cancer rehabilitation services. Intervention research should adopt frameworks that enhance healthcare accessibility to improve relevance of intervention content and delivery features for older breast cancer survivors.
PURPOSE: Many older breast cancer survivors experience long-term disability due to cancer and cancer-related treatments. However, less than 20% of older breast cancer survivors utilize cancer rehabilitation services to address cancer-related disability. Further understanding of survivor experiences may reveal strategies to improve uptake cancer rehabilitation services in the USA. METHODS: Older breast cancer survivors were recruited from university-based registries, previous breast cancer research studies at our institution, community support groups, and geriatric oncology clinics. Participants completed a brief online survey to capture demographic and clinical characteristics. Semi-structured telephone-based interviews were recorded, transcribed, and thematically analyzed. Interviews facilitated conversation about access to rehabilitation and indications for cancer rehabilitation. RESULTS: Participants (n = 14) were, on average, 71 years old, primarily White, and an average of 36.5 months post-diagnosis. Five participants had formally received rehabilitation for a cancer-related concern. Participants described seven factors that influenced utilization of cancer rehabilitation services: (1) emerging awareness of disability; (2) coping styles; (3) comparison of cancer experience with others; (4) provider interaction; (5) perceptions of cancer diagnosis; (6) social support; and (7) cost of rehabilitation. CONCLUSIONS: Older breast cancer survivors consider multiple factors when determining utilization of cancer rehabilitation services. Development of shared decision-making tools addressing the seven described factors may enhance communication and referral to cancer rehabilitation services. Intervention research should adopt frameworks that enhance healthcare accessibility to improve relevance of intervention content and delivery features for older breast cancer survivors.
Authors: Jill J Francis; Marie Johnston; Clare Robertson; Liz Glidewell; Vikki Entwistle; Martin P Eccles; Jeremy M Grimshaw Journal: Psychol Health Date: 2010-12
Authors: Catherine M Alfano; Corinne R Leach; Tenbroeck G Smith; Kim D Miller; Kassandra I Alcaraz; Rachel S Cannady; Richard C Wender; Otis W Brawley Journal: CA Cancer J Clin Date: 2018-10-30 Impact factor: 508.702