Reported Experience of Women Who Received a New Self-management Physical Therapy Instruction before Breast Cancer Surgery - A Case Series

Abstract

Objective: The need to provide information and instruction for patients post breast cancer (BC) surgery is highly supported. Several studies have shown pre-surgery instruction to be beneficial. However, as information about the experience of patients receiving pre-surgery instruction is limited, this case series aims to describe the experience of nine individual women who received newly developed, updated, self-management physical therapy (PT) instruction before BC surgery. Methods: Participant interviews were conducted by telephone using a list of questions prepared in advance about their personal experience. Medical files provided demographic and medical data. Interviews were performed by one physical therapist, transcribed, and analysed by two co-authors. Similarities and differences between transcripts were summarized. Results: Most participants found the instruction content to be easily understood and beneficial. They also expressed the value of receiving instruction before BC surgery. Nine felt that the instruction should be routinely provided. Criticism was mainly for lack of instruction regarding pain control, dealing with exercise fear avoidance, and that women unfamiliar with self-management and independent exercise may benefit less. Conclusion: Most participants found the new instruction understandable and beneficial when provided pre-surgery. However, this may not be suitable practice for all women as some may need personalized post-surgery instruction. Therefore, in addition to pre-surgical instruction provision, a post BC surgery PT visit would identify those requiring individualized instruction. Information about outpatient PT services should be added to pre-surgery instruction. Future studies should examine content and provision timing in a large sample of participants.