What are the attitudes and beliefs of oncologists regarding potential cancer rehabilitation in a tertiary cancer center?

Knowledge, attitudes, and beliefs of oncology trainees on function and cancer rehabilitation medicine

BACKGROUND

Improved function is associated with reduced morbidity and mortality in patients with cancer. Cancer rehabilitation medicine (CRM) is a subspecialty of physical medicine and rehabilitation (PM&R) that focuses on improving function in patients with cancer. One of the barriers to patients accessing CRM services is the lack of referrals from oncology providers. Understanding the knowledge, attitudes and beliefs of oncology trainees regarding the importance of function and the role of CRM is essential to reducing educational gaps and improving patients' access to essential rehabilitation services.

OBJECTIVE

To determine oncology trainees' knowledge, attitude and beliefs about the importance of function and the role of CRM in the care of patients with cancer.

SETTING

The study was conducted at a comprehensive cancer center in the United States.

INTERVENTION

Descriptive survey study was administered to postgraduate oncology trainees who spent at least 1 day a week providing patient care.

MAIN OUTCOME

Participants' report of their knowledge, attitudes, and beliefs on the importance of function and CRM in the care of patients with cancer.

RESULTS

The survey was sent to 197 oncology trainees with a response rate of 67% (n = 132) and 126 were ultimately included. All participants believed that function is important in the care of patients with cancer. The majority believed that better function improves treatment tolerance (94%) and survival (84%). Most reported that having CRM physicians (80%) and an inpatient rehabilitation unit (88%) in the oncological setting is important; however, most participants reported that they refer fewer than 25% of their patients to CRM services. Participants with prior exposure to PM&R were significantly more likely to consult PM&R compared to those without exposure (p = .005). Most oncology trainees (81%) believed that education in CRM should be part of their oncology training.

CONCLUSION

This study demonstrates that oncology trainees believe that function is important. They also believe that access to CRM would improve treatment tolerance and survival, but most report that they rarely refer patients to CRM services. Most trainees desire increased exposure to CRM during oncology training.

Physiatrists’ Attitudes and Knowledge About Cancer Rehabilitation

Objective

We aim to assess the awareness and evaluation pattern among physiatrists regarding cancer rehabilitation and associated barriers to access.

Design

The present study is a cross-sectional study in the Physical Medicine and Rehabilitation (PMR) Association Annual Meeting in Puerto Rico that used a 10-item questionnaire to summarize physiatrists’ clinical patterns with their persons diagnosed with cancer (PDWCs).

Results

Thirty-eight (66.7%) participants answered they received minimal to no education about cancer rehabilitation benefits. Cancer patients represented 10% or less of the weekly patient load for 47 (82.5%) physiatrists surveyed. The most common type of cancer encountered was breast cancer for the management of adverse effects. Twenty-nine (50.9%) physiatrists answered that a multifactorial barrier was the cause for limited services within this population group. All participants agreed that rehabilitation is at least sometimes beneficial for cancer patients, and 54 (94.7%) believed these services are needed.

Conclusion

Although rehabilitation specialists learn about the benefits of rehabilitation for PDWCs, there continues to be a limited number of PDWCs evaluated, mainly due to poor access, lack of information about cancer rehabilitation, and economic difficulties. Further efforts should be made to emphasize the importance of integrating rehabilitation techniques in the care of PDWCs.

Oncologists' Attitude and Knowledge about Cancer Rehabilitation

INTRODUCTION

Cancer survivors may experience multiple comorbidities related to the disease itself and adverse effects from treatment. Rehabilitation specialists could provide treatment options; however, oncologic rehabilitation services are underutilized.

OBJECTIVE

To assess oncologists' awareness of the benefits of rehabilitation for cancer care patients and to identify barriers to rehabilitation referrals in adult cancer patients in Puerto Rico.

DESIGN

Cross-sectional study.

SETTING

Regional Annual Meeting of the Association of Medical Hematology and Oncology of Puerto Rico, 4-7 September 2015.

PARTICIPANTS

Forty-two oncologists.

INTERVENTIONS

Participants completed a 10-item questionnaire focused on demographics, knowledge, and clinical practices over the previous 12 months related to rehabilitation in cancer patients.

MAIN OUTCOME MEASURES

Frequency, reasons, and timing for oncologist referral of cancer patients to rehabilitation. Perceived risks and benefits of rehabilitation in cancer patients and their correlation to patient referrals, prognosis, type of cancer, and type of symptoms.

RESULTS

Thirty-seven oncologists (88.1%) received minimal or no education about cancer rehabilitation, its benefits, and indications. This resulted in 31 oncologists (73.8%) referring less than 15% of their patients for rehabilitation, with almost a third of participants referring less than 5%. However, 39 (92.9%) agreed that rehabilitation is always or frequently beneficial for their patients. Fifteen (35.7%) said they did not refer patients if prognosis was less than 6 months, and 16 (38.0%) avoided referring patients with life expectancy of less than 3 months.

CONCLUSIONS

Although medical oncologists have some knowledge that rehabilitation is beneficial for their patients, there is a low referral rate. This could be due to lack of information about cancer rehabilitation and limited access to cancer rehabilitation specialists. Further efforts should be made to improve access to rehabilitation care for cancer patients and survivors.