Healthcare practitioners (HCPs) play a role in cancer survivors’ approach to physical activity; however, HCPs are in need of additional education and practical support to provide patients with guidance, resources, and referrals, according to study results published in Supportive Care in Cancer.

A large body of research indicates the multiple benefits of exercise for cancer survivors to counteract adverse events and enhance their quality of life. But the guidelines developed for cancer survivors haven’t always made it into actual practice, given a number of survivor-related existing barriers such as time limitations, low mood, low exercise literacy, and importantly, a lack of referrals from their HCPs.

Therefore, a team of researchers investigated healthcare practitioners’ knowledge, beliefs, and practices regarding exercise counseling and referral of cancer survivors to exercise programs.


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The researchers conducted a cross-sectional online survey, which was completed by 375 participants between February 2020 and February 2021. Of those, approximately 40% were medical practitioners, 28% were nurses, 29% were nonexercise allied health practitioners, and 14% were exercise specialists.

Many participants were already aware of some gaps. “Between 35 and 50% of participants self-reported low levels of knowledge with respect to when, how, and which cancer survivors to refer to exercise programs or exercise specialists, and how to counsel based on exercise guidelines,” the researchers reported. “More than 90% of exercise specialists self-reported good knowledge in all domains.”

Other findings included:

  • More than half medical practitioners claimed to have good knowledge about which cancer survivors could be referred to a supervised program and how to refer them.
  • Although most said exercise should be part of routine care, only approximately 68% of the respondents reported that exercise counseling actually was a routine component of the care that they provide.
  • Participants who met guidelines for physical activity themselves were more likely to discuss exercise’s role in symptom management or provide specific exercise advice.
  • Almost all the participants (94%) favored exercise specialists as the best possible healthcare professional to discuss exercise with survivors.

The researchers also identified barriers to exercise counseling. The healthcare professionals who are not exercise professionals cited barriers such as safety concerns, time constraints, and a lack of knowledge about how to screen a survivor to gauge the suitability for exercise.

“Given that knowledge is a [hypothesized] to influence behavior change and was a key predictor of participants’ current practices, increasing educational and engagement opportunities for HCPs may support the implementation of exercise guidelines in their routine practice,” the researchers concluded.

Study limitations included diversity, as the survey was English-only, and the sample size was weighted toward female participants from high-income countries. “Given these limitations, the results can only serve as explorative in nature and may not be generalizable,” the researchers stated.

Disclosures: Some authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Reference

Ramsey I, Chan A, Charalambous A, et al. Exercise counselling and referral in cancer care: an international scoping survey of health care practitioners’ knowledge, practices, barriers, and facilitators. Support Care Cancer. Published online September 29, 2022. doi:10.1007/s00520-022-07342-6