C. Belchamber1, E. Rosser2, C. Ellis-Hill2
1AECC University College, School of Sport, Psychology and Physical Activity, Bournemouth, United Kingdom, 2Bournemouth University, Faculty of Health and Social Sciences, Bournemouth, United Kingdom
Background: Whilst it has been acknowledged that there is an increasing need for physiotherapists in palliative cancer care, there is a lack of understanding about the nature of their role, educational needs, and place within palliative cancer care rehabilitation teams.
Purpose: To explore a local palliative cancer care physiotherapy service provision in view of best practice recommendations.
Methods: A single qualitative case study design was chosen as it provided a framework for the inclusion of numerous perspectives in a multifaceted context within a specialist field of healthcare, where very little research has been carried out. This included four data sets: Semi-structured interviews (healthcare professionals [10]); semi-structured interviews (people with advanced cancer [10]); observations (physiotherapists [2] treating people with advanced cancer [5]); and policy document collection [12]). Detailed data analysis was undertaken using a thematic approach within an analytical framework comparing and contrasting patterns within and across the four data sets. NVivo (9.1) provided transparency, efficiency: logging the movement of the data; coding patterns, mapping conceptual categories, keeping memos of thoughts enabling all stages of the analytical process to be traceable and transparent.
Results: Emergent themes highlighted the need for physiotherapist to develop new ways of working, shifts in mindset and treatment planning, emotional adjustment and integration of professional boundaries in order to work successfully in palliative cancer care teams. This involved a metamorphosis of both the physiotherapist’s profession and service provision through entrepreneurial, leadership, policy championship and humanising skills, facilitating vital policy recommendations of service quality and innovation to be achieved.
Conclusion(s): This study provides an insight into the unique development of physiotherapy practice within a palliative cancer care team. It provides a framework and distinct perspective of physiotherapy educational needs and how physiotherapists must ‘prove their worth’ now that they are an integral part of the palliative cancer care team.
Implications: Firstly, the bottom up approach to policy implementation, integrated teamwork, sharing of skills, humanisation and transformational leadership are areas of increasing interest within the healthcare system and policy documentation. Secondly, physiotherapy training, education business planning and measurement of service provision in palliative cancer care needs to be addressed within the physiotherapy curriculum, so that graduates have a better understanding of managing people with cancer and picking up signs and symptoms that might otherwise be missed. Thirdly, post-graduate training in cancer care is a necessity for generalist physiotherapists who have a growing workload of cancer care service users requiring rehabilitation. Lastly there is a need for a recognised career pathway for physiotherapists in cancer care to enable capacity building within the palliative cancer care workforce.
Funding, acknowledgements: The authors gratefully acknowledge funding received from the CSP Charitable Trust, ACPOPC and Bournemouth University Fusion Investment Fund.
Keywords: Palliative, Cancer, Case study
Topic: Oncology, HIV & palliative care
Did this work require ethics approval? Yes
Institution: Bournemouth University
Committee: Berkshire Research and Ethics Committee
Ethics number: 09/H0505/108
All authors, affiliations and abstracts have been published as submitted.
