Implementing physical activity programs for patients with cancer in current practice: patients' experienced barriers and facilitators

J Cancer Surviv. 2019 Oct;13(5):703-712. doi: 10.1007/s11764-019-00789-3. Epub 2019 Jul 25.

Abstract

Purpose: The present study aimed to identify patients' experienced barriers and facilitators in implementing physical activity programs for patients with cancer.

Methods: We interviewed 34 patients in focus-group-interviews from three different hospital-types. We included patients with cancer who were either receiving curative treatment or had recently completed it. Barriers and facilitators were explored in six domains: (1) physical activity programs, (2) patients, (3) healthcare professionals (HCPs), (4) social setting, (5) organization, and (6) law and governance.

Results: We found 12 barriers and 1 facilitator that affect the implementation of physical activity programs. In the domain of physical activity programs, the barrier was physical activity programs not being tailored to the patient's needs. In the domain of patients, lacking responsibility for one's own health was a barrier. Knowledge and skills for physical activity programs and non-commitment of HCPs impeded implementation in the domain of HCPs. Barriers in the domain of organization included inconvenient place, time of day, and point in the health treatment schedule for offering the physical activity programs, inadequate capacity, inaccessibility of contact persons, lack of information about physical activity programs, non-involvement of the general practitioner in the cancer care process, and poor communication between secondary and primary HCPs. Insufficient insurance-coverage of physical activity programs was a barrier in the domain of law and governance. In the domain of physical activity programs, contact with peers facilitated implementation. We found no barriers or facilitators at the social setting.

Conclusions: Factors affecting the implementation of physical activity programs occurred in various domains. Most of the barriers occurred in the domain of organization.

Implications for cancer survivors: An implementation strategy that deals with the barriers might improve the implementation of physical activity programs and quality of life of cancer survivors.

Keywords: Cancer survivors; Health plan implementation; Healthcare quality improvement; Qualitative research; Rehabilitation.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Attitude of Health Personnel
  • Cancer Survivors / psychology
  • Cancer Survivors / statistics & numerical data
  • Communication Barriers*
  • Exercise Therapy / methods
  • Exercise Therapy / organization & administration*
  • Exercise Therapy / standards
  • Exercise*
  • Female
  • Focus Groups
  • Health Personnel
  • Health Services Accessibility* / standards
  • Health Services Accessibility* / statistics & numerical data
  • Health Services Needs and Demand
  • Humans
  • Implementation Science
  • Interviews as Topic
  • Male
  • Middle Aged
  • Neoplasms / epidemiology
  • Neoplasms / psychology
  • Neoplasms / therapy*
  • Patient Acceptance of Health Care* / psychology
  • Patient Acceptance of Health Care* / statistics & numerical data
  • Primary Health Care / organization & administration
  • Primary Health Care / standards
  • Primary Health Care / statistics & numerical data
  • Quality of Life
  • Social Facilitation