Cancer Rehabilitation in Australia and New Zealand

Abstract

Objective: Despite increasing evidence of the benefits of cancer rehabilitation worldwide, the nature of cancer rehabilitation programs is not well described in Australia and New Zealand. We report findings of a pilot survey highlighting the current service delivery of cancer rehabilitation programs and health professionals' perspectives on barriers and facilitators to implementation of cancer rehabilitation programs. Methods: A cross-sectional pilot survey of rehabilitation health professionals in hospital and ambulatory care settings in Australia and New Zealand, evaluating current availability of cancer rehabilitation programs, health professional workforce, core components delivered, and barriers and facilitators to provision and delivery of cancer rehabilitation programs. Results: Respondents (n = 60) included rehabilitation physicians and advanced trainees, with a majority of respondents working in non-dedicated cancer rehabilitation programs in Australia and New Zealand. Most rehabilitation programs being provided to cancer patients are led by rehabilitation physicians, followed by allied health. The most common tumor streams referred include central nervous system, hematological, and breast cancers. Patients are most frequently referred during posttreatment phase. The core components of rehabilitation programs include management of complications and provision of education (mood, exercise, and fatigue management), with exercise prescription comprising mainly strengthening exercises, mobilization, and gait training. Common barriers for adequate service delivery included inadequate funding and lack of appropriate staffing with expertise, while most common facilitators identified were encouraging better collaboration and integration of rehabilitation within acute cancer care services and specialty teams and increased enthusiasm and engagement of staff with leadership skills. Conclusion: The pilot survey identified current service provision among rehabilitation programs providing care to cancer patients and highlighted preliminary gaps and facilitators to the implementation of formal cancer rehabilitation programs. These findings need further confirmation in a larger study to assess further outcome measures and the impact of barriers and facilitators for care quality. Collaborative efforts between physicians, patients, policy makers, and related parties may assist in overcoming the barriers identified.