对澳大利亚西部地区癌症患者运动服务的可获得性和适宜性进行界定

Mr Christopher Andrew, Dr Annie De Leo, Dr Carolyn McIntyre, Dr Joshua Lewis, Dr Amy Dennett, Dr Yvonne Zissiadis, Dr Mar Kennedy
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摘要

国家指南指示肿瘤医护人员在标准护理中将患者转介给运动治疗,但在实践中却很少出现转介情况,导致研究与实践之间存在严重差距。阻碍转诊的一个主要障碍--尤其是在农村和地区--是缺乏适合癌症患者的运动计划。因此,本研究的目的是:1)确定西澳大利亚地区是否有肿瘤运动项目;2)探索这些资源是否适合满足该地区癌症患者的需求,以便为该地区创建全面的转诊资源。 通过全面的在线搜索,确定了该地区为癌症患者提供的所有运动服务。我们使用癌症康复到娱乐(CaReR)框架对服务进行了分类,以描述每种服务所提供的护理水平。该地区癌症患者的地理构成和人口统计学特征与服务相匹配,以确定服务差距。 西南部地区约有 19.4 万人,每年有 1300 名居民被诊断出患有癌症。经确认,有 66 项肿瘤运动服务适合为这部分人口提供服务。62%的项目位于该地区最大的两个郡。66% 的服务被归类为 CaReR 第 1 阶段,为高需求患者提供有针对性的监督护理;79% 为第 2 阶段,为中等需求患者提供有针对性的监督护理;28% 为第 3 阶段,为低需求患者提供独立的社区护理。 西南地区的资源严重不足,无法满足将运动转介纳入癌症患者护理的国家指令。这主要是由于缺乏针对这一人群的运动服务,以及很少有项目能满足患者的不同需求。需要开展以实施为重点的研究,以解决从研究到实践的这一关键差距。
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SCOPING THE AVAILABILITY AND APPROPRIATENESS OF EXERCISE SERVICES FOR PEOPLE WITH CANCER IN REGIONAL WESTERN AUSTRALIA
National guidance directs oncology healthcare professionals to refer patients to exercise in standard care, yet referrals happen rarely in practice resulting in a critical research-to-practice gap. One major barrier preventing referrals—especially in rural and regional areas—is the lack of appropriate exercise programming available to people with cancer. Therefore, the aims of this study are to 1) determine the availability of exercise oncology programs in a regional area of Western Australia; and 2) explore the appropriateness of these resources to meet the needs of people living with cancer in this region so that a comprehensive referral resource can be created for the region. A comprehensive online search identified all exercise services available in the region for people with cancer. Services were categorised using the Cancer Rehabilitation to Recreation (CaReR) framework to describe the level of care each provided. The geographical makeup and demographics of the cancer population in the region were matched to the services to identify service-gaps. Approximately 194 000 people live in the Soutwest, with ∼1300 residents diagnosed with cancer each year. Sixty-six exercise oncology services were identified as appropriate for serving this entire population. 62% of all programs were located in the two largest shires across the region. 66% of services were categorised as CaReR Phase 1, providing targeted, supervised care for high-needs patients; 79% as Phase 2, providing targeted, supervised care for medium needs patients; and 28 percent as Phase 3, independent, community-based care for low needs patients. The Southwest region is significantly under-resourced to meet the national directive to embed exercise referrals into care for people with cancer. Lack of available exercise services for this population, and few programs catering for a diverse range of patient needs underpin this. Implementation-focused research is required to address this critical research-to-practice gap.
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