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M. van der Velde1,2,3, I. Fransen4, K. Valkenet2,1, C. Veenhof2,1, E. Geleijn3, M. van der Leeden3,5
1University of Applied Science Utrecht, Innovation of Human Movement Care Research group, Utrecht, Netherlands, 2University Medical Center Utrecht, Utrecht University, Physical Therapy Science and Sports, Utrecht, Netherlands, 3Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam, Netherlands, 4Utrecht University, Clinical Health Sciences, Program Physiotherapy Sciences, Utrecht, Netherlands, 5Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
Background: Prehabilitation is the process of improving a patient’s functional capabilities prior to a surgical procedure. Nowadays, prehabilitation is gaining an increasingly important place within physiotherapy and rehabilitation, especially in the context of oncology care. Prehabilitation often consists of physical training, with additional attention to other (lifestyle) risk factors such as improving nutrition, mental counseling and smoking and alcohol cessation. Primary care physiotherapists play an important role within prehabilitation when it comes to physical training of the oncology patient.
Purpose: With the increasing importance of (multimodal) prehabilitation within oncology care, the substitution of hospital care with primary care, and the changing role of the physiotherapist, it seems of great value to explore physiotherapists’ perceptions of their role in prehabilitation. Therefore, the research question of this study is: How do primary care physiotherapists see their role in (multimodal) prehabilitation prior to cancer surgery?
Methods: In this qualitative study, semi-structured interviews were conducted with primary care physiotherapists treating oncological patients in the prehabilitation phase. Participants were recruited through existing networks and social media. An interview guide, which was tested during a pilot interview, was used during the interviews. All interviews were recorded and transcribed verbatim. Data was collected until data saturation was reached. Data analysis was conducted by three researchers. Using an inductive approach, categories and themes were identified.
Results: Thirteen primary care physiotherapists (12 women, 1 men) participated in this study. Their years of work experience differed between 6 and 42 years. How these physiotherapists perceive their role in (multimodal) prehabilitation emerged in two themes: the ‘therapist of physical fitness’ and the ‘key player in prehabilitation’. The roles as described in the Dutch Physiotherapy Professional Profile were used to further describe these themes.
Every physiotherapist sees himself or herself as a ‘therapist of physical fitness’. Within this theme physiotherapists mainly fulfill the role of ‘caregiver’ and ‘communicator’. Physiotherapists see it as their main task to improve the physical fitness of the patients in the prehabilitation phase. They see themselves as executors of care and are in close contact with the patient.
The ‘key player in prehabilitation’ also takes on other roles. Within this theme the physiotherapist fulfills the role of ‘organizer’, ‘collaborator’ and ‘health promotor’. They attribute to themselves more transcendent roles such as coordination and alignment of care and have an eye for other (lifestyle) risk factors in addition to physical fitness. Various barriers to fulfilling the roles were mentioned within these two themes.
Every physiotherapist sees himself or herself as a ‘therapist of physical fitness’. Within this theme physiotherapists mainly fulfill the role of ‘caregiver’ and ‘communicator’. Physiotherapists see it as their main task to improve the physical fitness of the patients in the prehabilitation phase. They see themselves as executors of care and are in close contact with the patient.
The ‘key player in prehabilitation’ also takes on other roles. Within this theme the physiotherapist fulfills the role of ‘organizer’, ‘collaborator’ and ‘health promotor’. They attribute to themselves more transcendent roles such as coordination and alignment of care and have an eye for other (lifestyle) risk factors in addition to physical fitness. Various barriers to fulfilling the roles were mentioned within these two themes.
Conclusions: This study provides insight into how primary care physiotherapists perceive their role within prehabilitation. Two main roles could be distinguished: the ‘therapist of physical fitness’ and the ‘key player in prehabilitation’. Future research should focus on how physiotherapists can be supported to fulfill these roles.
Implications: By examining the perceived roles of primary care physiotherapists, these physiotherapists can be supported in fulfilling these roles, and mutual expectations of healthcare professionals can be aligned to improve the quality and collaboration in the field of multimodal prehabilitation in primary care.
Funding acknowledgements: Unfunded
Keywords:
Prehabilitation
Primary care
Oncology care
Prehabilitation
Primary care
Oncology care
Topics:
Oncology, HIV & palliative care
Professional issues
Disability & rehabilitation
Oncology, HIV & palliative care
Professional issues
Disability & rehabilitation
Did this work require ethics approval? No
Reason: A declaration not subject to WMO was issued by the medical ethical committee of the Amsterdam University Medical Center. METc-nummer 2021.0789
All authors, affiliations and abstracts have been published as submitted.
