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Role of physiotherapy in supporting recovery from breast cancer treatment : a qualitative study embedded within the UK PROSPER trial

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PROSPER Study Group (Including: Rees, Sophie, Mazuquin, Bruno F., Richmond, Helen, Williamson, Esther and Bruce, Julie). (2021) Role of physiotherapy in supporting recovery from breast cancer treatment : a qualitative study embedded within the UK PROSPER trial. BMJ Open, 11 (5). e040116. doi:10.1136/bmjopen-2020-040116

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Official URL: https://doi.org/10.1136/bmjopen-2020-040116

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Abstract

Objectives: To explore the experiences of women with breast cancer taking part in an early physiotherapy-led exercise intervention compared with the experiences of those receiving usual care. To understand physiotherapists’ experience of delivering the trial intervention. To explore acceptability of the intervention and issues related to the implementation of the Prevention Of Shoulder Problems (PROSPER) programme from participant and physiotherapist perspective.

Design: Qualitative semistructured interviews with thematic analysis.

Setting: UK National Health Service.

Participants: Twenty participants at high risk of shoulder problems after breast cancer surgery recruited to the UK PROSPER trial (10 each from the intervention arm and control arm), and 11 physiotherapists who delivered the intervention. Trial participants were sampled using convenience sampling. Physiotherapists were purposively sampled from high and low recruiting sites.

Results: Participants described that the PROSPER exercise intervention helped them feel confident in what their body could do and helped them regain a sense of control in the context of cancer treatment, which was largely disempowering. Control arm participants expressed less of a sense of control over their well-being. Physiotherapists found the exercise intervention enjoyable to deliver and felt it was valuable to their patients. The extra time allocated for appointments during intervention delivery made physiotherapists feel they were providing optimal care, being the ‘perfect physio’. Lessons were learnt about the implementation of a complex exercise intervention for women with breast cancer, and the issues raised will inform the development of a future implementation strategy.

Conclusions: A physiotherapist-delivered early supported exercise intervention with integrated behavioural strategies helped women at risk of shoulder problems following breast cancer treatment to feel more confident in their ability to mobilise their arm post-surgery. A physiotherapist-delivered early supported exercise intervention with integrated behavioural strategies may address the sense of powerlessness that many women experience during breast cancer treatment.

Trial registration number ISRCTN35358984.

Item Type: Journal Article
Subjects: R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
SWORD Depositor: Library Publications Router
Library of Congress Subject Headings (LCSH): Breast -- Cancer -- Physical therapy
Journal or Publication Title: BMJ Open
Publisher: BMJ Publishing Group
ISSN: 2044-6055
Official Date: 11 May 2021
Dates:
DateEvent
11 May 2021Published
1 December 2020Accepted
Volume: 11
Number: 5
Article Number: e040116
DOI: 10.1136/bmjopen-2020-040116
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
Health Technology Assessment Program (13/84/10)National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
Research Capability FundingNational Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
Applied Research Collaboration Oxford and Thames ValleyNational Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272

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