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Follow the trail: Using insights from the growth of palliative care to propose a roadmap for cancer rehabilitation.
Literature Information
| DOI | 10.3322/caac.21549 |
|---|---|
| PMID | 30457670 |
| Journal | CA: a cancer journal for clinicians |
| Impact Factor | 232.4 |
| JCR Quartile | Q1 |
| Publication Year | 2019 |
| Times Cited | 9 |
| Keywords | evidence-based practice, neoplasms, policy, public opinion, rehabilitation |
| Literature Type | Journal Article, Research Support, Non-U.S. Gov't |
| ISSN | 0007-9235 |
| Pages | 113-126 |
| Issue | 69(2) |
| Authors | Kathleen D Lyons, Lynne S Padgett, Timothy F Marshall, Joseph A Greer, Julie K Silver, Vishwa S Raj, David S Zucker, Jack B Fu, Mackenzi Pergolotti, Alix G Sleight, Catherine M Alfano |
TL;DR
This article examines the low referral and uptake rates of cancer rehabilitation despite its benefits, drawing parallels with the successful growth strategies of palliative care in oncology. It identifies five key strategies—stimulating research, creating guidelines, building capacity, responding to public opinion, and advocating for policy changes—that could enhance the integration and effectiveness of cancer rehabilitation, ultimately improving the quality of life for cancer survivors.
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evidence-based practice · neoplasms · policy · public opinion · rehabilitation
Abstract
Despite research explicating the benefits of cancer rehabilitation interventions to optimize physical, social, emotional, and vocational functioning, many reports document low rates of referral to and uptake of rehabilitation in oncology. Cancer rehabilitation clinicians, researchers, and policy makers could learn from the multidisciplinary specialty of palliative care, which has benefited from a growth strategy and has garnered national recognition as an important and necessary aspect of oncology care. The purpose of this article is to explore the actions that have increased the uptake and integration of palliative care to yield insights and multimodal strategies for the development and growth of cancer rehabilitation. After examining the history of palliative care and its growth, the authors highlight 5 key strategies that may benefit the field of cancer rehabilitation: 1) stimulating the science in specific gap areas; 2) creating clinical practice guidelines; 3) building clinical capacity; 4) ascertaining and responding to public opinion; and 5) advocating for public policy change. Coordinated and simultaneous advances on these 5 strategies may catalyze the growth, utilization, and effectiveness of patient screening, timely referrals, and delivery of appropriate cancer rehabilitation care that reduces disability and improves quality of life for cancer survivors who need these services.
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Primary Questions Addressed
- What specific lessons can cancer rehabilitation learn from the referral processes established in palliative care?
- How can the integration of palliative care principles enhance the development of personalized rehabilitation plans for cancer survivors?
- In what ways can public awareness campaigns, similar to those in palliative care, be tailored to increase the uptake of cancer rehabilitation services?
- What role do interdisciplinary teams play in improving the effectiveness of cancer rehabilitation, as seen in the palliative care model?
- How can policy changes advocated for in palliative care be adapted to address barriers in cancer rehabilitation access and delivery?
Key Findings
Key Insights
1. Research Background and Purpose
Despite the established benefits of cancer rehabilitation in enhancing various aspects of patients' lives, including physical, social, emotional, and vocational functioning, there remains a significant gap in the referral rates and uptake of these services within oncology. This study aims to harness lessons from the growth of palliative care—a multidisciplinary field that has gained recognition as a critical component of oncology—to propose a comprehensive roadmap for advancing cancer rehabilitation. By examining how palliative care has successfully integrated into cancer treatment paradigms, the authors seek to identify actionable strategies that can similarly enhance the visibility and utilization of cancer rehabilitation services.
2. Main Methods and Findings
The authors conducted a historical analysis of palliative care's development and integration in oncology, identifying key strategies that have contributed to its success. They outlined five pivotal strategies for advancing cancer rehabilitation:
- Stimulating the science in specific gap areas: Focusing research efforts on underexplored aspects of cancer rehabilitation to generate evidence-based practices.
- Creating clinical practice guidelines: Establishing standardized protocols to ensure consistent and effective rehabilitation interventions.
- Building clinical capacity: Enhancing the training and resources available to healthcare professionals involved in cancer rehabilitation.
- Ascertaining and responding to public opinion: Engaging with patients and the public to understand their needs and to promote awareness of rehabilitation services.
- Advocating for public policy change: Lobbying for policies that support funding and resources for cancer rehabilitation services.
These strategies are intended to work in concert, creating a robust framework that can catalyze improvements in the delivery and uptake of cancer rehabilitation.
3. Core Conclusions
The authors conclude that a coordinated approach, informed by the successful strategies of palliative care, can significantly enhance the integration and effectiveness of cancer rehabilitation. By addressing the identified gaps and implementing the proposed strategies, healthcare providers can improve patient outcomes, reduce disability, and enhance the overall quality of life for cancer survivors who require rehabilitation services.
4. Research Significance and Impact
This study holds significant implications for the future of cancer care. By drawing parallels to palliative care, it provides a clear roadmap for stakeholders, including clinicians, researchers, and policymakers, to follow in order to elevate the status and implementation of cancer rehabilitation. The proposed strategies not only aim to increase the uptake of rehabilitation services but also spotlight the importance of holistic cancer treatment that encompasses both physical and psychological support. Ultimately, this work advocates for a systemic change in cancer care that recognizes and prioritizes the rehabilitation needs of survivors, thus fostering a more comprehensive approach to cancer recovery and survivorship.
Literatures Citing This Work
- Training and Practice Patterns in Cancer Rehabilitation: A Survey of Physiatrists Specializing in Oncology Care. - Raman Sharma;Diana Molinares-Mejia;Ashish Khanna;Susan Maltser;Lisa Ruppert;Sarah Wittry;Ryan Murphy;Anne Felicia Ambrose;Julie K Silver - PM & R : the journal of injury, function, and rehabilitation (2020)
- A health services research agenda to fully integrate cancer rehabilitation into oncology care. - Mackenzi Pergolotti;Catherine M Alfano;Alison N Cernich;K Robin Yabroff;Peter R Manning;Janet S de Moor;Erin E Hahn;Andrea L Cheville;Supriya G Mohile - Cancer (2019)
- Cancer Rehabilitation and Palliative Care-Exploring the Synergies. - Rabeya A Chowdhury;Frank P Brennan;Matthew D Gardiner - Journal of pain and symptom management (2020)
- A Survey of Cancer Rehabilitation Professionals Regarding Emerging Topics in the Field. - Jack B Fu;Paolo Tralongo - Journal of cancer rehabilitation (2020)
- Moving through cancer: Setting the agenda to make exercise standard in oncology practice. - Kathryn H Schmitz;Nicole L Stout;Melissa Maitin-Shepard;Anna Campbell;Anna L Schwartz;Chloe Grimmett;Jeffrey A Meyerhardt;Jonas M Sokolof - Cancer (2021)
- The Past, Present, and Future of American Cancer Rehabilitation. - Jack B Fu - Physical therapy research (2021)
- An Integrated Care Approach to Improve Well-Being in Breast Cancer Patients. - Alessandra Fabi;Alessandro Rossi;Edoardo Mocini;Ludovica Cardinali;Valerio Bonavolontà;Cristina Cenci;Stefano Magno;Vittoria Barberi;Antimo Moretti;Zein Mersini Besharat;Giovanni Iolascon;Carlo Baldari;Elisabetta Ferretti;Andrea Botticelli;Ida Paris;Giovanni Scambia;Silvia Migliaccio - Current oncology reports (2024)
- Sociodemographic and clinical characteristics associated with rehabilitation services utilization in older women with early-stage breast cancer from SEER-Medicare 2009-2018. - Jessica S Gorzelitz;Rachelle Brick;Luqin Deng;Michelle Mollica;Nicole Stout;Stefanie Stoller;Courtney P Williams - Journal of cancer survivorship : research and practice (2024)
- Editorial: Rehabilitation within the context of palliative care. - Marcos Montagnini;Christopher M Wilson - Frontiers in rehabilitation sciences (2024)
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