Cancer Rehabilitation Program Research Articles

Comparing the efficacy of a multi-dimensional breast cancer rehabilitation programme versus a home-based exercise programme during adjuvant cancer treatment

BackgroundBreast cancer is the most common female malignancy worldwide and a major cause of morbidity and mortality. Exercise during adjuvant treatment improves function and relieves symptoms in breast cancer survivors. However, it is unclear if an unsupervised exercise programme may be as effective as a supervised multimodal group. We investigated the feasibility and efficacy of a centre-based multidimensional rehabilitation (MDR) programme for breast cancer survivors undergoing adjuvant treatment and compared it to an unsupervised home-based exercise (HE) programme.MethodsParticipants were self-allocated to either MDR or HE group. MDR participants underwent 24 supervised exercise classes and 10 education classes over 12 weeks. HE participants were instructed on a home exercise regime. Outcome measures, including the 6-min walk test (6MWT) and Frenchay Activities Index (FAI), FACT-Cognitive Function scale, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30, were conducted at baseline (W0), post-intervention (W12) and 6-months post-intervention (M6). Variance between time points and the 2 groups were analysed using a linear mixed model (unstructured covariance matrix) and adjusted with Bonferroni.ResultTwenty-five participants attended at least half of the MDR interventions, while 21 completed the HE interventions. The former showed significant improvement in 6MWT, from 406.88 m (W0) to 443.34 m (W12) to 452.81 m (M6), while the improvement in the HE group was not significant (407.67 m (W0) to 433.14 m (W12) to 430.96 m (M6)). Both groups showed a significant improvement in FAI, with earlier significant improvement noted at W12 in the MDR group (22.71 (W0) to 27.65 (W12) to 28.81 (M6)) compared to the HE group (23.16 (W0) to 26.47 (W12) to 29.85 (M6)). Dropout rate was 16% in the MDR group and 34% in HE group. Overall satisfaction with the MDR programme was high.ConclusionBoth MDR and HE programmes were feasible. MDR was superior in improving endurance and earlier return to instrumental activities for those who completed at least half of the sessions. Future studies could explore use of technology to improve adherence to exercise.Trial registrationThe study was registered with ClinicalTrial.gov on 01/04/2022 with the registration number NCT05306808.

Using Performance Status to Identify Risk of Acute Care Transfer in Inpatient Cancer Rehabilitation

ObjectiveTo identify patient factors associated with acute care transfer (ACT) among cancer survivors admitted for inpatient medical rehabilitation. DesignAn exploratory, observational design was used to analyze retrospective data from electronic medical records. SettingData were obtained from 3 separate inpatient rehabilitation hospitals within a private rehabilitation hospital system in the Northeast. ParticipantsMedical records were reviewed and analyzed for a total of 416 patients with a confirmed oncologic diagnosis treated in 1 of the inpatient rehabilitation hospitals between January and December 2020. InterventionsNot applicable. Main Outcome MeasuresThe primary outcome measure was the incidence of an ACT. Covariates included the adapted Karnofsky Performance Scale (KPS) for inpatient rehabilitation, demographic information, admission date, re-admission status, discharge destination, and cancer-related variables, such as primary cancer diagnosis and presence/location of metastases. ResultsOne in 5 patients (21.2%) were transferred to acute care. Patients with hematologic cancer had a higher risk of ACT compared with those with central nervous system (CNS) cancer. Lower functional status, measured by the adapted KPS, was associated with a higher likelihood of ACT. Patients with an admission KPS score indicating the need for maximum assistance had the highest transfer rate (59.1%). ConclusionsThese findings highlight the medical complexity of this population and increased risk of an interrupted rehabilitation stay. Considering patients’ performance status, cancer type, and extent of disease may be important when assessing the appropriateness of IRF admission relative to patient quality of life. Earlier and improved understanding of the patient's prognosis will allow the cancer rehabilitation program to meet the patient's unique needs and facilitate an appropriate discharge to the community in an optimal window of time.

2095P Cancer rehabilitation program for cancer-related fatigue

2095P Cancer rehabilitation program for cancer-related fatigue

Utilization of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 scale for evaluation of quality of life among cancer patients treated with chemotherapy: A hospital-based observational study.

In this new era of cancer management, the quality of life (QOL) is given more importance than the quantity of life. QOL evaluation studies are widely used in oncology to assess the patient's performance in different cancer types and treatment modalities. To evaluate cancer patients' QOL after various chemotherapy cycles. An observational study was performed on cancer patients receiving chemotherapy in the daycare setting of a South Indian Tertiary Care Hospital for 6 months. European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) questionnaire was employed to study the QOL. Precisely, 102 patients participated in the study, out of which the majority were in the 51 to 60 age group (24%). Female participants (65%) were more. Functional scale domains especially physical ability (P = 0.004), role (P = 0.033), and emotional functioning (P = 0.01) were significantly decreased in patients treated with 4 to 6 chemotherapy cycles. Cognitive ability (P = 0.043) significantly improved in patients treated with more than 6 chemotherapy cycles. Dyspnea (P = 0.036) was significantly increased in patients treated with 4 to 6 chemotherapy cycles and decreased significantly with the further addition of chemotherapy cycles. Dyspnea is a commonly observed symptom among cancer patients and is often neglected by physicians. Chronic dyspnea can negatively impact a patient's functional ability. Cancer symptoms such as dyspnea should also be given priority and need appropriate treatment. Based on the findings, further interventions can be made to improve the functional ability of cancer patients. Also, studies can be conducted to correlate with cancer rehabilitation programs to improve functional ability and complete the entire chemotherapy cycle.

Cardiotoxicity and cancer care: scoping review exploring current home-based, self-management cancer care interventions

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): NHS Lothian Background/Introduction Cardiotoxicity is heart damage that occurs as consequence of some cancer treatments and drugs. Gaining a better understanding of current cancer prehabilitation and rehabilitation programmes, specifically facilitated, home-based programmes, can better illuminate how interventions can aid patients in their cancer, and possible cardiac journey. This scoping review sets out to explore the provision of multimodal, cancer prehabilitation and rehabilitation programmes available to patients. Home-based, self-management, multidimensional cancer interventions (HSMCIs) are increasing in number, due to the growing population of people living with and beyond cancer. These multimodal programmes target a range of physical and psychosocial factors to improve self-management and quality of life amongst cancer patients during prehabilitation and rehabilitation. However, preliminary searches indicate that the interventions vary significantly in their definitions of key terms, target demographics, implementation success and evidence-base. Purpose This scoping review aims to assess the nature, extent and remit of existing HSMCIs, identify their strengths, limitations, potential barriers to access and obstacles to their implementation, and clarify key terms and concepts within the field. Methods Key word searches were performed in AMED, Cochrane, PsychInfo, Medline, CINAHL and Embase databases from 2010 to 2022 to identify papers relevant to HSMCIs. Study characteristics for inclusion were home-based, multimodal, non-centre based interventions that dealt with prehabilitaton and/or rehabilitation for cancer patients, while incorporating psychological, physical and nutritional components. Results The search gleaned a total of 302 results. These results were screened independently by two investigators with a third member conducting spot checks to ensure rigor. Early findings were then cross-referenced and irrelevant papers and duplicates were removed. A total of 38 results remained that fulfilled inclusion criteria. The scoping review found that few programmes were truly multimodal taking a general approach to cancer, instead targeted one or two specific cancers. Fewer still had mention of cardiotoxicity and how to manage heart health during cancer treatment. Conclusions This scoping review has highlighted the gap for a HSMCI in care provision to cover the range of biopsychosocial support needed for those living with and beyond cancer. Consistent with earlier research it emphasises the necessity for promoting cardiovascular health in this population.

Patient Experiences of a Telehealth Multidisciplinary Cancer Rehabilitation Programme: Qualitative Findings from the ReStOre@Home Feasibility Study

Purpose. Multidisciplinary rehabilitation programmes providing exercise, nutrition support, education, and peer support can effectively meet the rehabilitation needs of upper gastrointestinal (UGI) cancer survivors. This study aimed to explore the experiences of participants who engaged in a telehealth, multidisciplinary rehabilitation programme for UGI cancer survivors. Methods. This single-arm feasibility study recruited participants who completed curative treatment for UGI cancer. Participants (n = 10, male = 9) aged 58–76 years were 5–17 months postsurgery. A 12-week telehealth rehabilitation programme was delivered via video call, consisting of group resistance training, remotely monitored aerobic training, 1 : 1 dietary counselling, 1 : 1 physiotherapy support, and group education sessions. Independent researchers conducted semistructured interviews at postintervention assessments. Transcripts were analysed using reflexive thematic analysis (RTA). Results. RTA of participant transcripts generated three overarching themes: (1) ReStOre@Home impacted psychosocial and physical needs by addressing a broad and meaningful gap in services, (2) paving a pathway towards prosperity, and (3) contrasting experiences with using technology. Participants’ preferences and recommendations for future telehealth programmes were discussed. Conclusions. A telehealth multidisciplinary rehabilitation programme supported participants in physical and psychosocial recovery. Qualitative analysis identified an important ongoing need for some in-person care and provided detailed insights into participant experiences during telehealth-delivered rehabilitation.

Rehabilitation outcomes for people with lung cancer (UNITE): protocol for the development of a core outcome set

IntroductionWith treatment-related improvements in survival, rehabilitation is essential to improve function and health-related quality of life and manage the high symptom burden associated with lung cancer. Despite this, significant heterogeneity...

Implementing a physiotherapy led cancer exercise programme in a National Cancer Centre: the FIXCAS study

ObjectivesTo examine the feasibility of implementing a 10-week exercise-based cancer rehabilitation programme in a national cancer centre. DesignA single-arm prospective feasibility study. SettingAn outpatient physiotherapy department. ParticipantsForty de-conditioned cancer survivors (<1 year post completion of treatment). InterventionsA 10-week programme of twice weekly group-based supervised exercise sessions. Main outcome measuresA mixed methods approach was used. The primary outcome of the study was feasibility, evaluated in terms of recruitment, adherence, attrition and stakeholder acceptance of the programme. Secondary outcomes examined the effect of the exercise intervention on physical function and quality of life measures. ResultsForty patients (age 60 (SD 10.6) years; n = 12 breast cancer, n = 11 lung cancer, n = 7 prostate cancer, n = 5 colorectal cancer, n = 5 other) participated. In total 82% (n = 33) participants completed the post-programme assessment. Deterioration of health and concerns over COVID-19 were the most common reasons for dropout (both n = 2). Adherence to both the supervised exercise classes and home exercise programme was high (78% and 94% respectively). No adverse events were recorded during the intervention or assessments. Qualitative feedback from stakeholders highlighted the acceptability of the programme as well as many perceived benefits of the exercise programme. Improvements in three quality of life sub-scales (physical function, role function and emotional function), physical activity levels and aerobic fitness levels were found post-intervention. ConclusionIt appears feasible to offer a 10-week exercise programme to patients attending a national cancer centre, with adequate recruitment, retention and adherence rates and high acceptability among stakeholders. Contribution of the Paper•It appears feasible to integrate exercise, an established and effective treatment options for various side effects of cancer treatments, into the care of patients living with cancer.•Further trials investigating the implementation of exercise programmes into real-world, standard practice settings are needed.

Patients' perceived challenges, competencies, and supportive care needs during acute clinical treatment of breast or gynecological cancer.

This study aimed to examine challenges, competencies, and supportive care needs (SCN) of women with breast or gynecological cancer during acute cancer treatment and associations to other health-related variables. We surveyed 120 patients with breast or gynecological cancer at the end of acute cancer treatment, either directly after surgery or during adjuvant chemotherapy. We assessed challenges, subjective competencies, and SCN using a self-developed measure comprising 25 items referring to coping tasks assigned to six domains. In addition, patients' competencies and health literacy (HL) were assessed. Most patients felt at least moderately challenged by coping tasks concerning psychological distress (e.g., dealing with fears and insecurities, 70.2%; coping with cancer diagnosis, 69.6%) and physical complaints (e.g., dealing with a reduced physical capacity, 56.6%). About 42.5%-71.4% of patients who evaluated coping tasks as highly challenging felt competent to deal with these challenges themselves. Less than half of patients reported SCN, mainly regarding psychological concerns. The extent of challenging coping tasks, patients' perceived ability to overcome challenges themselves, and SCN showed associations to patient competencies and HL. SCN regarding psychological concerns and health behavior should be addressed in acute cancer care and rehabilitation programs. In addition, promoting HL might be essential in strengthening patients' subjective competencies related to various coping tasks.

Effects of virtual reality on physical, cognitive, and psychological outcomes in cancer rehabilitation: a systematic review and meta-analysis.

To systematically examine and summarize the current evidence regarding the effects of virtual reality (VR) on physical, cognitive, and psychological outcomes in cancer rehabilitation. Six bioscience and engineering databases were searched. Two independent reviewers screened the titles and abstracts of 2397 records and retrieved 25 full-text articles. Inclusion criteria included patients with a current or previous diagnosis of cancer; VR was used as an intervention for physical, cognitive, or psychological impairments and functional limitations; and clinical trials with at least two arms and with both pre- and post-intervention assessments. Reviewers assessed methodological quality using the Physiotherapy Evidence Database scale. Seventeen studies including 799 patients with cancer were identified. Within-group pooled analysis indicated that patients demonstrated significant improvement in pain (P < 0.001), fatigue (P < 0.001), anxiety (P < 0.001), upper extremity function (P < 0.001), and quality of life (P = 0.008) after VR intervention. Between-group pooled analysis indicated significant improvements with VR in pain (P = 0.004), anxiety (P < 0.001), and upper extremity function (P < 0.001) compared with thecontrol. Three studies reported the positive effects of VR on cognition. VR demonstrates promising effects in physical, cognitive, and psychological aspects of patients with cancer. VR can be incorporated into a comprehensive cancer rehabilitation program to alleviate impairments and functional limitations.

Steep ramp test protocol for preoperative risk assessment and short-term high-intensity interval training to evaluate, improve, and monitor cardiorespiratory fitness in surgical oncology.

Steep ramp test protocol for preoperative risk assessment and short-term high-intensity interval training to evaluate, improve, and monitor cardiorespiratory fitness in surgical oncology.

Community-Based Multidimensional Cancer Rehabilitation in Norway: A Feasibility Study.

Cancer survival is often accompanied by late effects that can be mitigated by tailored rehabilitation. In Norway, this has traditionally been offered as residential programs, whereas community-based cancer rehabilitation programs are lacking. This study aimed to assess the feasibility and acceptability of a newly developed community-based multidimensional cancer rehabilitation program in Norway. A feasibility study with a mixed methods explanatory sequential design was implemented. The intervention was a 12-week group-based rehabilitation program comprising 5 components: goal setting, physical exercise, psychoeducation, individual follow-up consultations, and peer support. Feasibility was assessed through recruitment, retention, and intervention delivery. Acceptability was assessed through intervention adherence and participant evaluation. Qualitative data were generated from focus group interviews. Statistical analyses were descriptive, and qualitative data were transcribed and analyzed using framework analyses. Sixty participants started, and 55 completed the 12-week rehabilitation program. The majority were female (80%), and the mean age was 56 years. The largest diagnostic group was breast cancer (42%). Retention was high (92%), as were adherence rates for all intervention components. The exercise component was rated the most beneficial, followed by individual consultations and peer support. Qualitative findings contributed to explaining the high adherence and positive evaluation. High retention, strong adherence, and positive evaluation imply that the community-based program was feasible and acceptable to cancer survivors. The results will aid intervention refinement and contribute to a future randomized controlled trial to examine its effectiveness. If successful, the rehabilitation program could be implemented in the Norwegian Cancer Pathway "Home."

Time to embed physical activity within usual care in cancer services: A qualitative study of cancer healthcare professionals’ views at a single centre in England

Purpose An increasing number of people affected by cancer (PABC) are living longer lives as treatment continues to advance. There is growing evidence for physical activity (PA) supporting health in this population before, during and after cancer treatment, but PA advice is not part of usual care. This study investigates views of frontline oncology healthcare professionals (HCPs) in one NHS teaching hospital in England to understand the role of PA advice across cancer services. Materials and methods This was a qualitative study interviewing HCPs and using thematic analysis. Results Four main themes were identified: 1. Awareness of the roles of PA in cancer; 2. Patient-specific factors in rehabilitation; 3. Cancer-specific factors in rehabilitation; 4. Barriers and opportunities to integrating PA within usual care. HCPs’ awareness of the role of PA in cancer rehabilitation was low overall and PA was found not to be embedded within rehabilitation. Contrastingly, there was awareness of PA’s potential to impact disease and treatment-related outcomes positively. Ideas for PA integration included training for staff and giving PA advice within consultations. Conclusions Low awareness of benefits of PA-based rehabilitation and lack of integration in usual care contrasted with HCPs’ interest in this area’s potential. Training HCPs to begin the conversation with patients affected by cancer in teachable moments may increase patient access. Implications for rehabilitation Integrating physical activity education and training for trainees and existing healthcare professionals workforce would help embed physical activity into routine clinical practice. Brief advice intervention training during every consultation, such as providing relevant individualised information and signposting, can be impactful. Physical activity within a broader cancer rehabilitation programme should be integrated as standard for every cancer patient. Individualised plans may include prehabilitation, restorative rehabilitation and palliative rehabilitation. Patient preferences and the patient experience should continue to shape service design. There is a need to ensure physical activity advice is consistent throughout healthcare settings and not fragmented between primary, secondary and tertiary care.

Currently available rehabilitation techniques for patients with gynecological cancer

The development of new rehabilitation techniques for cancer patients is relevant, on the one hand, due to the increasing cancer incidence, and, on the other hand, due to breakthroughs in cancer treatment. Following successful treatment, female patients often do not receive due attention since there are no recommendations for their further management. All patients with gynecological cancer undoubtedly need further medical and social support after cancer therapy since many of them face a lot of challenges related to impaired physiological functions, psychological problems, the need to rebuild professional and family relationships, i. e., decreasing quality of life. Therefore, there is an obvious need for the development of cancer rehabilitation programs. This type of care must be available to everyone regardless of their social status, financial welfare and place of residence. The full spectrum of rehabilitation activities should be based on the latest researches and guidelines.

System-level barriers and facilitators to cancer rehabilitation delivery for children with cancer.

81 Background: Up to 20% of childhood cancer survivors suffer from a significant physical function impairment due to cancer or cancer treatment. Early intervention with Occupational Therapy (OT) and Physical Therapy (PT) increases engagement in personal care, leisure interests, school-based tasks, return to work, and prevents cognitive decline. Despite this, less than 30% of childhood cancer survivors receive PT services. To date, facilitators and barriers to implementing cancer rehabilitation (CR) for pediatric cancer survivors have not been adequately explored. Thus, the aim of this research was to identify system-level barriers and facilitators to CR delivery based on surveys completed by hospital administrators, oncology physicians, advanced practice providers, and OT/PT therapists. Methods: A cross-sectional method was employed. Three previously published cardiac rehabilitation delivery instruments specific for administrators, OT/PT therapists and clinical providers respectively were adapted to evaluate CR delivery. All surveys used a 5-point Likert-type response format (e.g., 1 = strongly disagree to 5 = strongly agree). Surveys ranged from 12 items (therapist survey) to 23 items (administrator survey). Questions pertained to knowledge, attitudes, and perceptions regarding CR. Results: A total of 20 administrators (mean age, 49.95 years old, 65% non-Hispanic White, 65% female), 20 providers (mean age, 43.4 years old, 71.4% non-Hispanic White, 67% female), and 20 therapists (mean age, 38.3 years old, 70% non-Hispanic white, 84% female) completed surveys. Administrators’ results indicated mid-range CR knowledge (median: 3.5; IQR 2,5), and all perceived CR as important or extremely important to outpatient care (median: 5; IQR 4,5). Limited insurance coverage and lack of space were the top barriers identified by administrators. Eighty percent of providers endorsed that clinical practice guidelines promote CR referral (median 4; IQR 4,5) and none reported being skeptical of CR benefits. Provider-identified barriers included an inconvenient referral process, lack of CR patient-education materials, and inadequate information on external CR resources. Therapists identified rate of absenteeism and referral rates as barriers to CR. Ninety percent of therapists reported hybrid CR delivery (supervised and unsupervised exercise) could facilitate CR participation (median 4; IQR 4,4). Conclusions: System-wide, there was adequate knowledge and positive perceptions and attitudes regarding CR. However, we identified multiple barriers presenting opportunities for multilevel interventions. These included: insurance coverage advocacy, streamlining referral processes to CR services, providing information on external CR programs, providing patient education materials, and leveraging hybrid CR delivery to optimize participation.

Exercise Based Cancer Rehabilitation Program Improves Phase Angle In Breast Cancer Survivors

Phase angle (PhA) is an index of cell membrane integrity and is a prognostic indicator of survival and quality of life in cancer survivors. The efficacy of exercise-based cancer rehabilitation programs (ExCR) on PhA is unknown. PURPOSE: To assess the effect of ExCR on PhA in breast cancer survivors. METHODS: Seventy female breast cancer survivors (61 ± 9 years, PhA 4.57 ± 0.51) were referred to the ExCR by their oncologist and participated in one-on-one exercise-based training for 90 minutes, 3 times a week, for 12 weeks. Training sessions included 30 minutes of cardiorespiratory training at intensities between 40-85% of heart rate reserve with a rate of perceived exertion (RPE) between 3-8, 45 minutes of resistance training (including both muscular strength and endurance) at intensities between 40-85% of 1 repetition maximum with an RPE between 3 and 8, and 15 minutes of flexibility training including both dynamic and static stretching. Participants completed pre and post assessments for muscular strength, muscular endurance, cardiorespiratory endurance, flexibility, body composition and PhA (Inbody 770). The results of the initial assessment were used to develop individualized exercise prescriptions. RESULTS: PhA significantly increased (p<0.05) after ExCR (PhApre = 4.56; PhApost = 4.63; Δ = 1.9%). Improvements in PhA show a positive correlation with improvements in muscular strength (incline bench press, r=0.45, p<0.0001; seated cable row, r=0.51, p<0.0001, latissimus dorsi pulldown, r=0.55, p<0.0001; leg press, r=0.39, p=0.0007; leg curl, r=0.43, p=0.0002; leg extension, r=0.38, p=0.0014; and grip strength, r=0.57, p<0.0001), cardiorespiratory endurance (VO2 peak, r=0.41, p=0.0008),and flexibility (sit and reach, r=0.35, p=0.0009). CONCLUSION: A 12-week ExCR significantly improves PhA in breast cancer survivors. Improvements in PhA are significantly positively correlated with improvements in muscular strength, cardiorespiratory endurance, and flexibility. The improvements in fitness are likely due to enhanced neuromuscular function, which may represent restoration of damaged cell membranes from cancer and cancer related treatments.

CREATE Childhood Cancer Rehabilitation Program development: Increase access through interprofessional collaboration.

Cancer and its treatment can lead to functional limitations affecting ongoing development in children and adolescents. We developed a pediatric cancer rehabilitation program that integrates evidence-based rehabilitative care into cancer treatment. The program utilizes the CREATE (collaboration, rehabilitation/research, education, assessment, treatment, evaluation) Childhood Cancer Rehabilitation model. We aim to describe the structural and process components of our rehabilitation program and provide an access and utilization analysis. To evaluate the rehabilitation program, we identified new patients with oncologic diagnoses from 2002 to 2019 using our database. To evaluate rehabilitative care, descriptive data, including the timing and type of rehabilitation services utilized within 5years of a child's diagnosis, were collected and reviewed. Statistical analysis focused on change over time. Among 1974 children assessed, 1580 (80.0%) received care from at least one rehabilitation service. Between 2002 and 2018, the percentage of children receiving rehabilitation services grew significantly throughout all disciplines, except for outpatient speech-language pathology. Utilization differed by age and diagnosis. Integrating therapists in the clinic improved patient access, reduced the time to access outpatient services, and increased the number of attended visits. Additional factors supporting program growth included: identifying leaders, using a prospective surveillance model, education, and program evaluation. A multimodal interprofessional approach, such as the CREATE model, improves access to and the efficiency of evidence-based rehabilitation services promoting recovery, ongoing development, and quality of life.

Mentalization and Its Relation to Life Satisfaction and the Level of Mental Adjustment to Illness in Women with Breast Cancer-A Pilot Study.

This study’s aim was assessing of the relationship between mentalization and life satisfaction and the level of adaptation to oncological disease in patients with breast cancer. The study involved 41 women (M = 59.88; SD = 8.81) with breast cancer who completed their treatments and participated in a cancer rehabilitation program. In the study, we used the Mentalization Questionnaire (MZQ), the Satisfaction Life Scale (SWLS), and the Mini-Mental Adjustment to Cancer Scale (Mini-MAC). The mean of declared level of mentalization was 45.54 (SD = 11.65). The significant correlation between mentalization (its general value and individual dimensions) and satisfaction with life/mental adjustment to cancer was observed. The strongest positive correlations were noted between refusing self-reflection, helplessness–hopelessness, and anxious preoccupation and the negative correlation between mentalization and satisfaction with life. Mentalization was a predictor of satisfaction with life and mental adjustment to illness. Mentalization was related with life satisfaction and adjustment to cancer in patients with breast cancer, which is in line with previous studies suggesting the crucial role of subjective psychological factors in maintaining mental health.

Efficacy of Group Exercise-Based Cancer Rehabilitation Delivered via Telehealth (TeleCaRe): Protocol for a Randomized Controlled Trial.

BackgroundAccess to rehabilitation to support cancer survivors to exercise is poor. Group exercise–based rehabilitation may be delivered remotely, but no trials have currently evaluated their efficacy.ObjectiveWe aimed to evaluate the efficacy of a group exercise–based cancer rehabilitation program delivered via telehealth compared to usual care for improving the quality of life of cancer survivors.MethodsA parallel, assessor-blinded, pragmatic randomized controlled trial with embedded cost and qualitative analysis will be completed. In total, 116 cancer survivors will be recruited from a metropolitan health network in Melbourne, Victoria, Australia. The experimental group will attend an 8-week, twice-weekly, 60-minute exercise group session supervised via videoconferencing supplemented by a web-based home exercise program and information portal. The comparison group will receive usual care including standardized exercise advice and written information. Assessments will be completed at weeks 0 (baseline), 9 (post intervention), and 26 (follow-up). The primary outcome will be health-related quality of life measured using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire at week 9. Secondary measures include walking capacity (6-minute walk test), physical activity (activPAL accelerometer), self-efficacy (Health Action Process Approach Questionnaire), and adverse events. Health service data including hospital length of stay, hospital readmissions, and emergency department presentations will be recorded. Semistructured interviews will be completed within an interpretive description framework to explore the patient experience. The primary outcome will be analyzed using linear mixed effects models. A cost-effectiveness analysis will also be performed.ResultsThe trial commenced in April 2022. As of June 2022, we enrolled 14 participants.ConclusionsThis trial will inform the future implementation of cancer rehabilitation by providing important data about efficacy, safety, cost, and patient experience.Trial RegistrationAustralian New Zealand Clinical Trials Registry ACTRN12621001417875; https://tinyurl.com/yc5crwtrInternational Registered Report Identifier (IRRID)PRR1-10.2196/38553

Patient Comments on a Hospital- and University-Based Exercise Oncology Program.

The purpose of this study was to identify referral source and patient-reported factors that promoted follow-through and participation in exercise oncology rehabilitation programs. A three question open-ended survey was administered to patients enrolled in trainer-supervised, hospital-based (n = 101), or university-based (n = 17) cancer rehabilitation program that provided 12weeks of individualized one on one aerobic and resistance training 1-3days per week. Significant themes for each question were as follows: Question #1. Who referred you to the program/facility? Oncology team (Χ2 = 145.814 P ≤ 0.001); Question #2. What convinced you to follow through with the referral? Health, fatigue, and need for supervision (Χ2 = 74.814 P ≤ 0.001); and Question #3. What motivates you to continue in the program? Personal results, getting healthy, and the trainer (Χ2 = 108.729 P ≤ 0.001). In this study, oncology team referral confirms previous work. Patient follow-through and continuation appear largely self-motivated as patients' health and the attainment of health through personal results are primary motivators for continuation in the program. Question #3 responses note the importance of the trainer in maintaining continuation in an exercise oncology rehabilitation program.