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Tang C1,2,3, Turczyniak M1, Sayner A1, Haines K1, Peel Z4, Butzkueven S4, Violet J5, OÇonnell H6
1Western Health, Physiotherapy, Footscray, VIC, Australia, 2Western Sydney University, Physiotherapy, Penrith, NSW, Australia, 3La Trobe University, Physiotherapy, Bundoora, Australia, 4Western Health, Cancer Services, Footscray, Vic, Australia, 5Peter MacCallum Cancer Centre, Radiotherapy, Melbourne, VIC, Australia, 6Western Health, Urology, Footscray, VIC, Australia
Background: Prehabilitation, a program that is implemented prior to commencement of treatment, has growing evidence to support its effectiveness in improving physical and mental wellbeing for people with prostate cancer. However, patient engagement in such programs is low. Experience based co-design (EBCD) is an innovative and systematic methodology that creates an authentic partnership between health professionals and consumers. There is increasing evidence supporting its effectiveness in improving patient engagement in health services programs, particularly within cancer cohorts internationally. However, there have yet to be any study utilising such methodology to develop a prehabilitation program for patients with prostate cancer.
Purpose: The aims of the study were to a) identify both positive experiences and challenges across the journey of receiving or implementing treatment for prostate cancer, as well as opportunities for improvement, and b) develop a prehabilitation program for patients receiving active treatment for prostate cancer as a potential solution to improve the experience.
Methods: Patients, carers and health professionals were selectively identified and recruited from two metropolitan tertiary teaching hospitals within Melbourne in Australia. Selection criteria included a) recent clinical/patient experience with prostate cancer treatment at either recruitment sites, b) willingness to participate in two workshop sessions and c) having both positive experiences and challenges to share during the workshops. All participants committed a minimum of seven hours to the study, including attendance at two, 2-hour face-to-face workshops. Participants from a non-English speaking background were also involved in the project with the assistance of an interpreter. A thematic analysis was conducted to identify key themes addressing the aims of the study.
Results: Twenty participants including eight patients, one carer and 11 health professionals were recruited for the study. All participants acknowledged that staff at both recruitment sites were highly experienced and had positive interactions between patients and health professionals. The most common challenge identified was the lack of a structured and sustainable approach in identifying and preparing patients for prostate cancer treatment. All participants were in agreeance that a structured prehabilitation program, that includes a group exercise program, pelvic floor strengthening exercises and education, would be beneficial. Practical ideas included timing of program implementation post diagnosis, content (including topics for education), strategies to boost engagement including engagement of other cultural groups, location and use of a health coach, and social interaction opportunities were clearly identified from the data.
Conclusion(s): All participants agreed that a prehabilitation program would add value to potentially improve outcomes and the experience for patients receiving active treatment for prostate cancer. A clearly defined structure for the program was identified through the EBCD process. A future study is required to pilot this program, to evaluate the effectiveness of engaging men in a prehabilitation program and improving their outcomes.
Implications: This study provides an insight to the overall patient experiences when undergoing treatment for prostate cancer and highlights the potential of physical therapists to be more involved in rehabilitation for cancer patients. The results from the study will guide physical therapists in the development of future prehabilitation programs for other cancer cohorts.
Keywords: Prostate cancer, Prehabilitation, Experience-based Co-design
Funding acknowledgements: This project has received funding from the Western Central Melbourne Integrated Cancer Service.
Purpose: The aims of the study were to a) identify both positive experiences and challenges across the journey of receiving or implementing treatment for prostate cancer, as well as opportunities for improvement, and b) develop a prehabilitation program for patients receiving active treatment for prostate cancer as a potential solution to improve the experience.
Methods: Patients, carers and health professionals were selectively identified and recruited from two metropolitan tertiary teaching hospitals within Melbourne in Australia. Selection criteria included a) recent clinical/patient experience with prostate cancer treatment at either recruitment sites, b) willingness to participate in two workshop sessions and c) having both positive experiences and challenges to share during the workshops. All participants committed a minimum of seven hours to the study, including attendance at two, 2-hour face-to-face workshops. Participants from a non-English speaking background were also involved in the project with the assistance of an interpreter. A thematic analysis was conducted to identify key themes addressing the aims of the study.
Results: Twenty participants including eight patients, one carer and 11 health professionals were recruited for the study. All participants acknowledged that staff at both recruitment sites were highly experienced and had positive interactions between patients and health professionals. The most common challenge identified was the lack of a structured and sustainable approach in identifying and preparing patients for prostate cancer treatment. All participants were in agreeance that a structured prehabilitation program, that includes a group exercise program, pelvic floor strengthening exercises and education, would be beneficial. Practical ideas included timing of program implementation post diagnosis, content (including topics for education), strategies to boost engagement including engagement of other cultural groups, location and use of a health coach, and social interaction opportunities were clearly identified from the data.
Conclusion(s): All participants agreed that a prehabilitation program would add value to potentially improve outcomes and the experience for patients receiving active treatment for prostate cancer. A clearly defined structure for the program was identified through the EBCD process. A future study is required to pilot this program, to evaluate the effectiveness of engaging men in a prehabilitation program and improving their outcomes.
Implications: This study provides an insight to the overall patient experiences when undergoing treatment for prostate cancer and highlights the potential of physical therapists to be more involved in rehabilitation for cancer patients. The results from the study will guide physical therapists in the development of future prehabilitation programs for other cancer cohorts.
Keywords: Prostate cancer, Prehabilitation, Experience-based Co-design
Funding acknowledgements: This project has received funding from the Western Central Melbourne Integrated Cancer Service.
Topic: Oncology, HIV & palliative care; Women's & men's pelvic health; Disability & rehabilitation
Ethics approval required: Yes
Institution: Peter MacCallum cancer centre and Western Health
Ethics committee: Peter MacCallum cancer centre human research ethics
Ethics number: HREC/18/PMCC/14
All authors, affiliations and abstracts have been published as submitted.
