Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2024

Embedding behaviour change discussion within oncology exercise referral: a qualitative study (#447)

Christopher J McHardy 1 , Jia (Jenny) Liu 2 3 4 , Roy T.H. Cheung 1 , Haryana Dhillon 5
  1. School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia
  2. The University of Sydney, Camperdown, NSW, Australia
  3. St Vincent's Clinical School, University of New South Wales, Darlinghurst, NSW, Australia
  4. The Kinghorn Cancer Centre, St Vincent's Hospital, Darlinghurst, NSW, Australia
  5. Psycho-Oncology Cooperative Research Group, The University of Sydney, Sydney, NSW, Australia

Background: Exercise during cancer treatment reduces treatment-related side effects. However, fewer than 20% of patients are referred for exercise intervention.

Aims: We explored acceptability of a structured exercise referral template aimed at facilitating discussion of exercise behaviours, barriers, and enablers.

Methods: We conducted a prospective qualitative study. A one-page exercise referral form (ERF) was co-designed with cancer healthcare professionals (CHCPs) and exercise specialists (ES). Semi-structured interviews were conducted on Zoom, recorded, transcribed, and analysed using Interpretative Description methods to facilitate translation into practice. Interviews continued until information power was achieved for two separate groups: cancer health care professionals; exercise providers.

Results: CHCPs (n=28) and ES (n=8) consented to being interviewed.

The ERF was found comprehensive, though likely time consuming to complete. Nursing staff were considered ideal to complete the ERF given their frequent patient interaction and scope of practice. Oncologists acknowledged the authority imbued within their recommendations, warranting referral by them. Surgeons were not willing to use ERF rather advocating exercise, with their support team completing referrals. Knowledge of chronic disease management funding options and exercise program cost facilitated referral.

CHCPs need training to know what information is valued by ES to optimise consult time for both professional groups. ES requested more cancer treatment details to guide exercise prescription. Behaviour change insights would help optimise ES time across initial assessment and treatment, enabling deeper psycho-social conversations with patients. Both professional groups acknowledged bi-directional communication would benefit exercise knowledge development and patient care.

Conclusion: Behavioural change questions embedded into oncology ERF may prompt deeper exercise discussion and improve patient preparedness for exercise. Identification of an exercise champion within the multidisciplinary team may facilitate team commitment to exercise referrals. Context adapted ERF may increase patient engagement and streamline referral at each respective clinical site.