An integrated model of exercise support for people affected by cancer: consensus through scoping

Abstract

Introduction

Exercise support for people with cancer is a national priority. The purpose of this study was to identify the success factors necessary to create a model of exercise support for people affected by cancer in a large city in the north of England.

Method

Two groups of participants were recruited; people affected by cancer (n = 26) and professional stakeholders (n = 14) contributing to either focus groups or semi-structured interviews. Data were analysed using framework analysis.

Results

Results from this study suggest that the promotion of exercise is not a priority in routine cancer care. Patients identified a lack of support and difficulty attaining information as a barrier to becoming active, emphasising a gulf between the patients’ needs and the health professionals’ priorities. People affected by cancer and professionals agreed that exercise was beneficial to cancer patients both during and after treatment. For an exercise pathway to be successful, key factors were identified including accessibility; tailored support; social interaction; affordability; competence of exercise delivery staff.

Conclusions

There was consensus on the importance of exercise and critical factors required to develop a sustainable, accessible and effective service. Evidence to inform the development of an exercise pathway for people affected by cancer is provided.

Implications for rehabilitation

• Exercise should be an included component of a cancer treatment plan, discussed and initiated from diagnosis.

• Health professionals have a responsibility to provide clear, consistent evidence-based advice on exercise.

• Exercise professionals must be appropriately trained in cancer rehabilitation according to National Institute for Health and care Excellence (2014).

• Individual assessments of exercise needs, preferences and cancer limitations will result in a bespoke plan of recommendations and support.

• The option of group activities has the advantage of increased social interaction, peer support and shared experiences.

• Available exercise/physical activity services should be accessible and affordable but may involve a modest contribution.

Keywords:

• Exercise referral
• exercise
• physical activity
• cancer survivorship
• barriers

Acknowledgements

The authors express gratitude to all the participants involved in the study. The authors also thank Emeritus Professor of Health Services Research at Sheffield Hallam University, Prof Karen Collins on her contributions to the early design of the study. Diana Greenfield is a National Institute for Health Research (NIHR) Senior Nurse Research Leader. The views expressed in this article are those of the author and not necessarily those of the NIHR, or the Department of Health and Social Care.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was funded by a research award from Weston Park Cancer Charity, Sheffield.