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This paper aims to report on a systematic review of qualitative studies on men's reflections on participating in cancer rehabilitation. Nine databases were systematically searched to identify qualitative papers published between 2000 and 2013. Papers were selected by pre-defined inclusion criteria and subsequently critically appraised. Key themes were extracted and synthesised. Fifteen papers were selected and represented. Four central themes were identified in the analytical process: 'changed life perspective', 'the masculinity factor', 'a desire to get back to normal' and 'the meaning of work'. Six peripheral themes were identified: 'the meaning of context', 'music', 'physical training', 'religion', 'humour' and 'the unmentionable'. The themes were synthesised into an integrative model representing men's reflections on participating in cancer rehabilitation. We conclude that existing qualitative literature offers insight into men's reflections on cancer rehabilitation and highlights the interrelationship between men's reflections on their changed life perspective, masculinity, orientation towards a normal life and getting back to work. Further research-based knowledge is needed to explore (1) the underlying causes and patterns of the men's needs, preferences and choices in rehabilitation; and (2) the health professional perspective on male cancer rehabilitation. [ABSTRACT FROM AUTHOR]

The author discusses several papers about cancer treatment and survivorship given the growing number of cancer survivors worldwide who are enduring side effects they have to manage. These include a study by C Handberg et al which describes the aim of cancer rehabilitation, a pilot study by KM Heinrich et al which describes the efficacy of a high-intensity functional training programme among cancer survivors and one by T Mitchell which focused on healthcare professionals with history of cancer.

Objective: The goal of this study was to investigate barriers to utilisation of cancer rehabilitation by querying a large sample of various professionals in health care with a comprehensive set of barriers. Methods: We developed a questionnaire comprising 55 barriers to utilisation of cancer rehabilitation and administered it to four different types of medical, care and social work experts involved in the referral to cancer rehabilitation. An exploratory factor analysis was conducted and the extracted factors were ranked by mean values. Additionally, ANOVAs were calculated to test for group differences. Results: Our sample (N = 606) consisted of 249 physicians, 194 social workers, 105 nurses and 55 psychologists in Germany. We identified seven barrier‐dimensions: low appreciation of rehabilitation by professionals, insufficient coordination, insufficient application procedure, rehabilitation requirements not met, patients' unfulfilled demands, patients' social responsibilities and patients' coping style, with the latter being rated as the most obstructive thereof. Furthermore, we found statistically significant group differences for six of these factors with small‐ to medium‐sized effects. Conclusion: Our results support previous publications implicating the patients' coping style as a barrier. We furthermore found evidence for barriers relating to processes and organisational issues, thereby expanding on the scope of patient‐oriented publications. Suggestions for improving patients' health services accessibility are made. [ABSTRACT FROM AUTHOR]

Objective: This study aims to report HRQOL, patient activation and physical functioning of haematological patients, participating in a 6‐month multimodal interdisciplinary rehabilitation programme HAPPY, when undergoing non‐myeloablative allogeneic haematopoietic stem cell transplantation (NMA‐HSCT). Methods: A prospective single‐arm longitudinal design. Outcomes were collected as part of a feasibility study and included: HRQOL (EORTC QLQ‐C30), patient activation measure (PAM), cardiorespiratory capacity (VO2peak), leg extensor power, lean body mass, measured pre‐NMA‐HSCT at 3‐, 6‐ and 12‐month follow‐up. Results: Thirty (mean age (SD) 64.1 (6.5)) out of 34 patients participated and 18 completed HAPPY. Outcome measures showed large individual differences of decline and improvement during follow‐up. Patients rated HRQOL as good (median 70.8; range 33.3–100). Fatigue, dyspnoea, insomnia and appetite loss mainly remained or worsened. PAM stayed in the upper half of range (median 55.6; range 20.5–84.8) with a trend towards improvement at 12‐month follow‐up. Physical functioning scores were low [i.e. baseline VO2peak, men median 1.5 L/min range (1.0–2.9), women 1.0 L/min (0.8–1.4), leg extensor power men 2.1 Watt/kg range (1.3–3.8), women 1.7 Watt/kg (1.3–2.4), lean body mass men 19.5% (17.6–24.9) and women 17.8% (15.3–21.7)]. Conclusion: The sustained low level of physical functioning and symptoms 12‐month after NMA‐HSCT emphasise the need for pre‐rehabilitation and long‐lasting rehabilitation support in this frail patient group. [ABSTRACT FROM AUTHOR]

Advances in the early detection of cancer and the development of more effective treatments have resulted in a larger number of adolescents and young adults ( AYAs), becoming cancer survivors. However, knowledge regarding their needs and if those needs are adequately addressed remains limited. The aims of this study were to: (1) better understand the needs of AYAs after cancer treatment; (2) analyse the importance of those needs; (3) determine which needs are not adequately addressed; and (4) test the hypothesis that AYA cancer survivors have different needs than adult survivors. Twenty-nine health oncology professionals, 17 AYA survivors and 12 relatives of AYA survivors participated in the Delphi study. The needs identified could be classified into six categories, and all were rated as highly important by all participants. The category perceived as least adequately addressed across the three groups was 'Counselling and psychological support.' The findings provide important new information regarding the needs of AYA cancer survivors that can inform the development of interventions to improve the quality of life of these individuals. [ABSTRACT FROM AUTHOR]

Quality of life (QoL) is impaired in many cancer patients. The aim of this study was to test whether detriments in QoL were less pronounced in global assessments of QoL compared to more specific components. A total of 2059 cancer patients with mixed diagnoses were examined 6 months after discharge from a cancer rehabilitation clinic. QoL was measured with the EORTC QLQ-C30, which contains a global QoL scale, and 14 functioning and symptom scales and symptom items. A sample of the general population ( n = 4476) served as controls. Regression analyses were performed to calculate expected mean scores for the patients, based on their age and gender distribution. Global QoL in the cancer sample (M = 69.3) was nearly equal to that of the general population, while the mean scores of all functioning scales, symptom scales and symptom items showed markedly worse QoL. This general relationship between global and specific QoL was found for seven of eight cancer types. The results indicate that global QoL is not the sum of its parts. This should be considered when treatment effects on QoL are examined. One alternative is to use higher order summarising functioning and symptom scales. [ABSTRACT FROM AUTHOR]

The aim was to describe male cancer survivors' barriers towards participation in cancer rehabilitation as a means to guiding future targeted men's cancer rehabilitation. Symbolic Interactionism along with the interpretive descriptive methodology guided the study of 35 male cancer survivors representing seven cancer types. Data were generated through a 5-month fieldwork study comprising participant observations, semi-structured individual interviews and informal conversations. The analyses revealed two overarching findings shedding light on male cancer survivors' barriers to rehabilitation: 'Fear of losing control' and 'Striving for normality'. While 'Fear of losing control' signified what the men believed rehabilitation would invoke: 'Reduced manliness', 'Sympathy and dependency' and 'Confrontation with death', 'Striving for normality' was based on what the men believed rehabilitation would hinder: 'Autonomy and purpose', 'Solidarity and fellowship' and 'Forget and move on'. This study of male cancer survivors' and cancer rehabilitation documents how masculine ideals may constitute barriers for participation in rehabilitation and provides insights about why men are underrepresented in rehabilitation. The findings can guide practice to develop research-based rehabilitation approaches focused on preserving control and normality. Further empirical evidence is needed to: (1) explore the conduct of health professionals' towards male cancer patients and (2) address gender inequalities in cancer rehabilitation. [ABSTRACT FROM AUTHOR]

Patterns of follow-up and survivorship care are changing in response to growing numbers of cancer survivors and an increasing recognition that traditional models are unsustainable and result in unmet needs. Clinicians have shown reluctance in changing conventional follow-up practices for patients with head and neck cancer. This study aimed to explore nurses' and allied health professionals' views and practices in relation to follow-up, holistic needs assessment and survivorship care in this patient group. An online survey of members of the British Association of Head and Neck Oncology Nurses was undertaken. The response rate was 43% (74 of 174). Findings revealed a range of existing models of follow-up, rehabilitation and support for people with head and neck cancer across the UK. Specialist staff were open to new models of care and to more responsibility, with adequate training and supervision. There were some gaps in the provision of comprehensive survivorship care and some specific areas of practice in which nurses lacked confidence, knowledge and skills, such as managing medications and complex symptoms. Further research is needed to develop and evaluate effective models of follow-up and support for a growing population of head and neck cancer survivors who have diverse and complex needs. [ABSTRACT FROM AUTHOR]

An existing 12-week cancer rehabilitation group programme, combining physical training and psychosocial sessions, was recently tested in a quantitative longitudinal cohort study ( n = 658) among adult patients who have problems coping with cancer. Results showed improvements in all quality of life domains. The objective of the present study was to explore patients' perspectives on how and to what extent the rehabilitation programme had met their needs in order to optimize the programme. Patients who participated in the programme no longer than 5 years ago were interviewed in three focus groups ( n = 23). Participants saw rehabilitation as provided by the programme as an important steppingstone in their ongoing recovery process and identified the integrated physical training, psychosocial sessions and patient-to-patient contacts as a powerful and supportive combination. Recommendations for improvements to the programme mainly concerned the psychosocial module. Information needs varied strongly among participants and, in this respect, it was hard to satisfy all of them. Participants suggested that the programme should focus more on developing skills to cope with cancer, its consequences and emerging problems after rehabilitation. In conclusion, participants valued the group-based multi-modal cancer rehabilitation programme and recommended to focus more on developing coping skills. [ABSTRACT FROM AUTHOR]

Despite proven benefits of regular physical activity, the majority of breast cancer survivors do not meet recommended physical activity guidelines. The Motivation–Volition (MoVo) Concept was designed to help people to set up and maintain a health‐enhancing lifestyle. Studies have proven the short‐ and long‐term efficacy of the MoVo intervention programmes. The intervention consists of four group sessions (60 min). The sessions contain informational parts, structured training in setting goals, planning exercises, problem‐solving, single person working and group discussion. We apply a sequential control group design in two inpatient rehabilitation facilities to evaluate the effect of a motivational–volitional group intervention compared to standard rehabilitation. Our target groups are inactive women after breast cancer. Primary outcome is the amount of physical activity per week. Secondary outcomes include physical functioning, fatigue and depression. 800 patients diagnosed with breast cancer on medical rehabilitation will be included, 400 participants per clinic and group. Participants will be assessed by questionnaires upon clinic arrival, before discharge and six and twelve months after discharge. The study will provide evidence on the effect of a MoVo group intervention for physical inactive women after breast cancer. Positive results may have an impact on long‐term improvement in exercise behaviour and health status. [ABSTRACT FROM AUTHOR]

Objective: The facilitation of complex cancer rehabilitation interventions in primary health care has become of growing importance to meet the bio‐psycho‐social needs of cancer survivors. However, the delivery of cancer rehabilitation is debated and services are underutilised. Cancer coordinators (CCs) provide patients with coordinated services throughout the trajectory. Little is known about CCs' rehabilitation‐focused tasks. This study's objective was to explore Norwegian CCs' experiences with cancer rehabilitation interventions in primary health care. Methods: Data were obtained via two focus group interviews with 12 participants, analysed using thematic analysis and discussed using Salutogenesis, a theory for health promotion. Results: The analysis revealed three themes: (a) "A missing link" to cancer rehabilitation in primary health care, (b) Aiming to put cancer rehabilitation "in the spotlight," (c) The need to build a system for rehabilitation service delivery. Conclusion: CCs experience a lacking focus on and missing systems for cancer rehabilitation in primary health care. CCs aim to improve local practices by advocating patients' needs and educating professionals. CCs must be supported via education and training in system‐level work, an increased policy focus and resources for cancer rehabilitation. More research is required into how CCs may facilitate cancer rehabilitation in primary health care. [ABSTRACT FROM AUTHOR]