Cowan-Dickie S1, Sandsund C1,2, Macleod H1, Moore C1
1The Royal Marsden NHS Foundation Trust, Rehabilitation Therapy, London, United Kingdom, 2University of Southampton, Health Sciences, Southampton, United Kingdom
Background: Breast cancer is the most common cancer diagnosed in the UK with 86% and 74% surviving to five and ten years respectively, the number of people diagnosed is predicted to rise significantly [1]. People treated for breast cancer who are more physically active experience less toxicity, reduced risk of recurrence, better quality of life and survival [2,3,4,5].
The services that healthcare professionals provide, aim to support people to be physically active to recommended levels of 150mins of moderate activity/ week and two sessions of resistance training [6]. Feedback from health professionals and people treated at our UK Cancer Centre suggest that the service is not achieving this aim.
Purpose:
1. To understand the current experience for those receiving and delivering services promoting physical activity (PA) for people with breast cancer treated at our Centre
2. To engage patients and staff in identifying priorities for service improvement with respect to promoting PA.
Methods: An experience-based co-design (EBCD) approach was used in the data gathering phase of this single-site service evaluation [7]. Potential participants were approached to recruit a diverse cohort to semi-structured interviews or focus groups that were audio or video recorded and facilitated using a topic schedule. They were eligible if they were >18 years old, had mental capacity, adequate English and received breast cancer treatment at our Centre; or, were staff involved in the service. The findings are presented at a joint event where priorities for service improvement are identified and participants are self-selected into working co-design groups.
Results: Work began in March 2018 following institutional approvals from the Committee for Clinical Research. Non-participant observation, interviews and data analysis were undertaken by the authors. Sixteen patients and 23 staff took part. Findings were presented at a joint event attended by 20 staff and patients. They identified that current services supported some patients well but, this is not being delivered equitably with concerns about rising demand. It highlighted that some health professionals do not feel confident about delivering PA information. Participants identified the following priorities for co-design groups:
1. Improving the knowledge of the health professionals about PA for people treated for breast cancer
2. Designing a systematic yet personalised, patient-led approach, supported by health professionals
3. To explore timing options for the delivery of PA services
4. Creating 'space' in PA services for peer support in 'groups' where patient and staff expertise is shared.
Conclusion(s): Current services to support patients in achieving recommended PA levels following treatment for breast cancer were inequitable, not systematically delivered or individualised to clinical need and will not meet future demands on the service. This impacts on current and future patients' experience of care, symptom control, risk of recurrence and overall survival rates. Identified priority areas for improvement will be developed with people who have experienced the service and health professionals working together. Novel models of service delivery will be tested for effectiveness in clinical practice.
Implications: Understanding the current experience for those receiving and delivering services was key to identifying priorities for service improvement in future PA services.
Keywords: breast cancer, physical activity, service co-design
Funding acknowledgements: Travel expenses were reimbursed from Rehabilitation Therapies Charitable Funds. Catherine Sandsund acknowledges support from the Royal Marsden Cancer BRC/ NIHR.
The services that healthcare professionals provide, aim to support people to be physically active to recommended levels of 150mins of moderate activity/ week and two sessions of resistance training [6]. Feedback from health professionals and people treated at our UK Cancer Centre suggest that the service is not achieving this aim.
Purpose:
1. To understand the current experience for those receiving and delivering services promoting physical activity (PA) for people with breast cancer treated at our Centre
2. To engage patients and staff in identifying priorities for service improvement with respect to promoting PA.
Methods: An experience-based co-design (EBCD) approach was used in the data gathering phase of this single-site service evaluation [7]. Potential participants were approached to recruit a diverse cohort to semi-structured interviews or focus groups that were audio or video recorded and facilitated using a topic schedule. They were eligible if they were >18 years old, had mental capacity, adequate English and received breast cancer treatment at our Centre; or, were staff involved in the service. The findings are presented at a joint event where priorities for service improvement are identified and participants are self-selected into working co-design groups.
Results: Work began in March 2018 following institutional approvals from the Committee for Clinical Research. Non-participant observation, interviews and data analysis were undertaken by the authors. Sixteen patients and 23 staff took part. Findings were presented at a joint event attended by 20 staff and patients. They identified that current services supported some patients well but, this is not being delivered equitably with concerns about rising demand. It highlighted that some health professionals do not feel confident about delivering PA information. Participants identified the following priorities for co-design groups:
1. Improving the knowledge of the health professionals about PA for people treated for breast cancer
2. Designing a systematic yet personalised, patient-led approach, supported by health professionals
3. To explore timing options for the delivery of PA services
4. Creating 'space' in PA services for peer support in 'groups' where patient and staff expertise is shared.
Conclusion(s): Current services to support patients in achieving recommended PA levels following treatment for breast cancer were inequitable, not systematically delivered or individualised to clinical need and will not meet future demands on the service. This impacts on current and future patients' experience of care, symptom control, risk of recurrence and overall survival rates. Identified priority areas for improvement will be developed with people who have experienced the service and health professionals working together. Novel models of service delivery will be tested for effectiveness in clinical practice.
Implications: Understanding the current experience for those receiving and delivering services was key to identifying priorities for service improvement in future PA services.
Keywords: breast cancer, physical activity, service co-design
Funding acknowledgements: Travel expenses were reimbursed from Rehabilitation Therapies Charitable Funds. Catherine Sandsund acknowledges support from the Royal Marsden Cancer BRC/ NIHR.
Topic: Oncology, HIV & palliative care
Ethics approval required: No
Institution: The Royal Marsden NHS Foundation Trust (RM)
Ethics committee: n/a
Reason not required: This project conducted to investigate the changing needs of patients and staff in oncology practice and as such was peer-reviewed and approved as a service evaluation and approved by a sub-committee of the RM Committee for Clinical Research
All authors, affiliations and abstracts have been published as submitted.
