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Participation in adequate physical activity improves the health status of cancer survivors, enhances their survival, and reduces their risk of cancer recurrence. However, cancer survivors engage in low levels of physical activity and have limited access to rehabilitation services that could increase their participation. No optimal framework has been developed that supports physical activity participation among cancer survivors. Given the growth in numbers of cancer survivors, development of a framework may provide a pathway to facilitate timely and appropriate care. This perspective paper describes the development of the Cancer Rehabilitation to Recreation (CaReR) Framework and its practical implications. The CaReR Framework uses a tailored, stepped approach to guide health services and clinicians on the design and implementation of interventions to promote physical activity among cancer survivors. Implementation of the CaReR Framework will improve continuity and quality of care for cancer survivors and promote physical activity with the ultimate aim of improving health outcomes. [ABSTRACT FROM AUTHOR]

Best practice recommendations in cancer care increasingly call for integrated rehabilitation services to address physical impairments and disability. These recommendations have languished primarily due to a lack of pragmatic, generalizable intervention models. This perspective paper proposes a clinically integrated physical therapist (CI-PT) model that enables flexible and scalable services for screening, triage, and intervention addressing functional mobility. The model is based on (1) a CI-PT embedded in cancer care provider clinics, and (2) rehabilitation across the care continuum determined by the patient's level of functional mobility. The CI-PT model includes regular screening of functional mobility in provider clinics via a patient-reported mobility measure—the Activity Measure for Post-Acute Care, a brief physical therapy evaluation tailored to the specific functional needs of the individual—and a tailored, skilled physical therapist intervention based on functional level. The CI-PT model provides a pragmatic, barrier-free, patient-centric, data-driven approach to integrating rehabilitation as part of standard care for survivors of cancer. The model standardizes CI-PT practice and may be sufficiently agile to provide targeted interventions in widely varying cancer settings and populations. Therefore, it may be ideal for wide implementation among outpatient oncological settings. Implementation of this model requires a shared approach to care that includes physical therapists, rehabilitation administrators, cancer care providers, and cancer center administrators. [ABSTRACT FROM AUTHOR]

Background: The primary objective of this paper is to consider whether holiday taking may have a role to play post diagnosis/treatment, within the rehabilitation process for cancer patients. Method: A qualitative study was undertaken. Informants consisted of cancer patients (n = 24), their family members (n = 13) and friends (n = 2), consultants (n = 2) pediatric oncology nurses (n = 2), social workers (n = 52), a voluntary services coordinator (n = 51), and a play specialist (n = 1). All were accessed through four facilitators at Christie Hospital, National Health Service Trust, Manchester, United Kingdom. Data were collected via interviews, telephone discussions, letters, personal accounts, and health diaries between January 2000 and March 2001. Questions were as ked regarding the perceived effects of travel during serious illness, travel propensity, and factors inhibiting full participation. Results: Benefits to health and well being, particularly of a sociopsychological nature, were identified. Such benefits impacted upon personal health, social effectiveness, personal identity, self-image, independence, future career prospects, and personal behavior. Factors inhibiting travel included the side effects of treatment, other peoples' reactions to the visible signs of cancer (e.g., hair loss, surgical scars), inflated insurance costs, a lack of holiday information sources, and communication issues (e.g., language barriers). Conclusions: Holiday taking offers a vehicle for transcending illness, even if only for a short period of time. Travel offered a range of therapeutic opportunities as well as providing a necessary means of escapism. Promoting travel as part of the rehabilitation process may well generate more intrinsic benefits than are currently appreciated. Such benefits may also be of broader application to patients facing other similarly complex illnesses. [ABSTRACT FROM AUTHOR]