Healthcare provider perspectives on a clinical decision tool to support individualized exercise prescriptions and discussions for breast cancer survivors.
Jinani Jayasekera, Oliver W A Wilson, Kaitlyn M Wojcik, Eleanor M Kerr, Rachelle Brick, David Berrigan, Jennifer Yeong-Shin Sheng, Takeo Fujii, Kathleen Thomas, Henri K Parson, Padma Sheila Rajagopal, Richard L Street
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Abstract
Purpose: We evaluated healthcare providers' current knowledge, practices, and perspectives on a novel clinical decision tool (beta-version) to facilitate individualized exercise prescriptions and discussions in clinical settings.
Methods: We recruited healthcare providers who had treated or provided care to breast cancer survivors aged ≥ 35-years in the past 12 months. The participants were presented with a tool to provide individualized exercise recommendations considering women's individual, clinical, and contextual characteristics. Validated and reliable pre-existing instruments were used to survey providers' current knowledge, practices regarding exercise discussions, and perspectives on the beta-version (paper-draft) of the novel tool.
Results: The sample consisted of complete survey responses from 177 healthcare providers including breast oncologists (27.7%), primary care physicians (10.7%), exercise specialists (19.8%), occupational/physical therapists (18.1%), advanced care providers, nurses, navigators, and social workers (23.7%). Median years of experience was 8-years (range: 5-13). Overall, 62.1% (n = 110) reported that they were knowledgeable about counseling survivors based on exercise guidelines. Among breast oncologists and primary care physicians (n = 68), only 39.7% reported that they were knowledgeable about identifying patients for exercise referals. The majority agreed that they would find the tool offering individualized information useful (n = 148, 83.6%), and would use it regularly to inform practice (82.5%). 'Exercise Readiness', 'Exercise Resources at Home', and 'Quality-of-Life' were the highest rated items for inclusion in the tool for exercise prescriptions. Provider perspectives were incorporated into the beta-version of the tool.
Conclusion: A clinical decision tool considering individual, clinical, and contextual characteristics may support exercise prescriptions and discussions in clinical settings.
Implications for cancer survivors: An evidence-based tool for exercise prescriptions may increase healthcare provider confidence to discuss, educate, encourage, and provide exercise referrals for breast cancer survivors.
期刊介绍：
Cancer survivorship is a worldwide concern. The aim of this multidisciplinary journal is to provide a global forum for new knowledge related to cancer survivorship. The journal publishes peer-reviewed papers relevant to improving the understanding, prevention, and management of the multiple areas related to cancer survivorship that can affect quality of care, access to care, longevity, and quality of life. It is a forum for research on humans (both laboratory and clinical), clinical studies, systematic and meta-analytic literature reviews, policy studies, and in rare situations case studies as long as they provide a new observation that should be followed up on to improve outcomes related to cancer survivors. Published articles represent a broad range of fields including oncology, primary care, physical medicine and rehabilitation, many other medical and nursing specialties, nursing, health services research, physical and occupational therapy, public health, behavioral medicine, psychology, social work, evidence-based policy, health economics, biobehavioral mechanisms, and qualitative analyses. The journal focuses exclusively on adult cancer survivors, young adult cancer survivors, and childhood cancer survivors who are young adults. Submissions must target those diagnosed with and treated for cancer.
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