Factors influencing utilization of cancer rehabilitation services among older breast cancer survivors in the USA: a qualitative study
Factors influencing utilization of cancer rehabilitation services among older breast cancer survivors in the USA: a qualitative study
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DOI：
10.1007/s00520-021-06678-9
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发表时间：
2021-11-11
影响因子：
3.1
通讯作者：
Leland, Natalie E.
中科院分区：
文献类型：
--
作者：
Brick, Rachelle;Lyons, Kathleen Doyle;Leland, Natalie E.
许多老年乳腺癌幸存者由于癌症和癌症相关治疗而经历长期残疾。然而，不到20%的老年乳腺癌幸存者利用癌症康复服务来解决癌症相关的残疾。进一步了解幸存者的经验，可能会揭示战略，以提高在美国的癌症康复服务。方法从大学登记处、本机构先前的乳腺癌研究、社区支持团体和老年肿瘤诊所招募老年乳腺癌幸存者。参与者完成了一项简短的在线调查，以获取人口统计学和临床特征。半结构化的电话访谈记录，转录，并进行主题分析。访谈促进了关于获得康复和癌症康复指征的对话。结果参与者（n = 14）平均年龄71岁，主要是白色，平均诊断后36.5个月。五名参与者因癌症相关问题正式接受康复治疗。参与者描述了影响癌症康复服务利用的七个因素：（1）对残疾的新认识;（2）应对方式;（3）与他人的癌症经历比较;（4）提供者互动;（5）对癌症诊断的看法;（6）社会支持;（7）康复费用。结论老年乳腺癌幸存者在确定癌症康复服务的利用时考虑多种因素。开发解决上述七个因素的共同决策工具，可以加强癌症康复服务的沟通和转诊。干预研究应采用增强医疗保健可及性的框架，以改善干预内容和老年乳腺癌幸存者的交付功能的相关性。
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.