A scoping review examining the integration of exercise services in clinical oncology settings

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dc.contributor.authorEzenwankwo, Elochukwu F
dc.contributor.authorNnate, Daniel A
dc.contributor.authorUsoro, Godspower D
dc.contributor.authorOnyeso, Chimdimma P
dc.contributor.authorAnieto, Ijeoma B
dc.contributor.authorIbeneme, Sam C
dc.contributor.authorAlbertus, Yumna
dc.contributor.authorLambert, Victoria E
dc.contributor.authorEzeukwu, Antoninus O
dc.contributor.authorAbaraogu, Ukachukwu O
dc.contributor.authorShamley, Delva
dc.date.accessioned2022-04-11T19:55:29Z
dc.date.available2022-04-11T19:55:29Z
dc.date.issued2022-02-21
dc.date.updated2022-02-27T04:12:34Z
dc.description.abstractBackground Addressing questions surrounding the feasibility of embedding exercise service units in clinical oncology settings is imperative for developing a sustainable exercise-oncology clinical pathway. We examined available literature and offered practical recommendations to support evidence-based practice, policymaking, and further investigations. Methods Four thousand eight hundred sixty-three unique records identified in Embase, CINAHL, MEDLINE, Web of Science Core Collection, and ProQuest (Health and Medicine) were screened for studies that recruited cancer patients, assessed the co-location of exercise service and cancer treatment units, and reported findings on service implementation. Evidence from six studies providing data from over 30 programs was integrated using narrative synthesis. Results Service implementation was relatively modest across the included studies. Exercise services were delivered by physiotherapists, exercise physiologists, and kinesiologists and funded mainly through grants and private donations, with staff salaries accruing as the major expense. Service penetration, adoption, and acceptability were generally low. However, studies recorded high clinician/patient satisfaction. Major barriers to service integration were limited funding, lack of detailed implementation plan, and low organizational buy-in. Common reasons for non-utilization, missed sessions, and dropouts were lack of interest, unwellness, hospital readmission, disease progression, and adverse skeletal events. Conclusion Implementing exercise services in clinical oncology settings seems an effective approach for increasing access to exercise-based rehabilitation for individuals on cancer treatment. While this model appears feasible for patients/clinicians, efforts are required to optimize service integration both in the short and long term. Key priorities include seeking [local] actions to address issues relating to funding and organizational buy-in. Important considerations may include developing an implementation plan to guide the implementation process, expanding the patient core management team to include staff from the exercise rehabilitation unit, and exploring the role of patient feedback in increasing clinician participation (e.g., treating oncologists and nurses) in the referral process. Future research should consider effective strategies to promote patients’ sense of self-efficacy and behavioral control and, further, the place of audit and feedback in improving exercise service delivery and overall service implementation.en_US
dc.identifier.apacitationEzenwankwo, E. F., Nnate, D. A., Usoro, G. D., Onyeso, C. P., Anieto, I. B., Ibeneme, S. C., ... Shamley, D. (2022). A scoping review examining the integration of exercise services in clinical oncology settings. <i>BMC Health Services Research</i>, 22(1), 236. http://hdl.handle.net/11427/36332en_ZA
dc.identifier.chicagocitationEzenwankwo, Elochukwu F, Daniel A Nnate, Godspower D Usoro, Chimdimma P Onyeso, Ijeoma B Anieto, Sam C Ibeneme, Yumna Albertus, et al "A scoping review examining the integration of exercise services in clinical oncology settings." <i>BMC Health Services Research</i> 22, 1. (2022): 236. http://hdl.handle.net/11427/36332en_ZA
dc.identifier.citationEzenwankwo, E.F., Nnate, D.A., Usoro, G.D., Onyeso, C.P., Anieto, I.B., Ibeneme, S.C., Albertus, Y. & Lambert, V.E. et al. 2022. A scoping review examining the integration of exercise services in clinical oncology settings. <i>BMC Health Services Research.</i> 22(1):236. http://hdl.handle.net/11427/36332en_ZA
dc.identifier.ris TY - Journal Article AU - Ezenwankwo, Elochukwu F AU - Nnate, Daniel A AU - Usoro, Godspower D AU - Onyeso, Chimdimma P AU - Anieto, Ijeoma B AU - Ibeneme, Sam C AU - Albertus, Yumna AU - Lambert, Victoria E AU - Ezeukwu, Antoninus O AU - Abaraogu, Ukachukwu O AU - Shamley, Delva AB - Background Addressing questions surrounding the feasibility of embedding exercise service units in clinical oncology settings is imperative for developing a sustainable exercise-oncology clinical pathway. We examined available literature and offered practical recommendations to support evidence-based practice, policymaking, and further investigations. Methods Four thousand eight hundred sixty-three unique records identified in Embase, CINAHL, MEDLINE, Web of Science Core Collection, and ProQuest (Health and Medicine) were screened for studies that recruited cancer patients, assessed the co-location of exercise service and cancer treatment units, and reported findings on service implementation. Evidence from six studies providing data from over 30 programs was integrated using narrative synthesis. Results Service implementation was relatively modest across the included studies. Exercise services were delivered by physiotherapists, exercise physiologists, and kinesiologists and funded mainly through grants and private donations, with staff salaries accruing as the major expense. Service penetration, adoption, and acceptability were generally low. However, studies recorded high clinician/patient satisfaction. Major barriers to service integration were limited funding, lack of detailed implementation plan, and low organizational buy-in. Common reasons for non-utilization, missed sessions, and dropouts were lack of interest, unwellness, hospital readmission, disease progression, and adverse skeletal events. Conclusion Implementing exercise services in clinical oncology settings seems an effective approach for increasing access to exercise-based rehabilitation for individuals on cancer treatment. While this model appears feasible for patients/clinicians, efforts are required to optimize service integration both in the short and long term. Key priorities include seeking [local] actions to address issues relating to funding and organizational buy-in. Important considerations may include developing an implementation plan to guide the implementation process, expanding the patient core management team to include staff from the exercise rehabilitation unit, and exploring the role of patient feedback in increasing clinician participation (e.g., treating oncologists and nurses) in the referral process. Future research should consider effective strategies to promote patients’ sense of self-efficacy and behavioral control and, further, the place of audit and feedback in improving exercise service delivery and overall service implementation. DA - 2022-02-21 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - BMC Health Services Research KW - Exercise-based rehabilitation KW - Service integration KW - Reach KW - Adoption KW - Cost KW - Utilization KW - Cancer care LK - https://open.uct.ac.za PY - 2022 T1 - A scoping review examining the integration of exercise services in clinical oncology settings TI - A scoping review examining the integration of exercise services in clinical oncology settings UR - http://hdl.handle.net/11427/36332 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s12913-022-07598-y
dc.identifier.urihttp://hdl.handle.net/11427/36332
dc.identifier.vancouvercitationEzenwankwo EF, Nnate DA, Usoro GD, Onyeso CP, Anieto IB, Ibeneme SC, et al. A scoping review examining the integration of exercise services in clinical oncology settings. BMC Health Services Research. 2022;22(1):236. http://hdl.handle.net/11427/36332.en_ZA
dc.language.isoenen_US
dc.language.rfc3066en
dc.publisher.departmentDepartment of Human Biologyen_US
dc.publisher.facultyFaculty of Health Sciencesen_US
dc.rights.holderThe Author(s)
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.sourceBMC Health Services Researchen_US
dc.source.journalissue1en_US
dc.source.journalvolume22en_US
dc.source.pagination236en_US
dc.source.urihttps://bmchealthservres.biomedcentral.com/
dc.subjectExercise-based rehabilitationen_US
dc.subjectService integrationen_US
dc.subjectReachen_US
dc.subjectAdoptionen_US
dc.subjectCosten_US
dc.subjectUtilizationen_US
dc.subjectCancer careen_US
dc.titleA scoping review examining the integration of exercise services in clinical oncology settingsen_US
dc.typeJournal Articleen_US
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