Background: Understanding patient experience is key to optimize access and quality of outpatient cancer rehabilitation (physical or occupational therapy, PT/OT) services. Methods: We performed a retrospective mixed-method analysis of rehabilitation medical record data to better understand patient experience and aspects of care that influenced experience. From the medical record, we extracted case characteristics, patient experience data (Net Promoter Survey^®, NPS) and patient-reported outcome (PRO) data. We categorized cases as ‘promoters’ (i.e., highly likely to recommend rehabilitation) or ‘detractors’, then calculated NPS score (−100 [worst] to 100 [best]). We identified key themes from NPS free-text comments using inductive content analysis, then used Pearson [r] or Spearman [ρ] correlation to explore relationships between NPS, characteristics, and PRO improvement. Results: Patients (n = 383) were 60.51 ± 12.02 years old, predominantly women with breast cancer (69.2%), and attended 14.23 ± 12.37 visits. Most were ‘promoters’ (92%); NPS score was 91.4. Patients described two experiences (themes) that influenced their likelihood to recommend rehabilitation: (1) feeling comfortable with the process and (2) observable improvement in health/functioning, and described attributes of clinic staff, environment and clinical care that influenced themes. Likelihood to recommend rehabilitation was associated with achieving the minimal clinical important difference on a PRO (ρ = 0.21, p < 0.001) and cancer type (ρ = 0.10, p < 0.001). Conclusion: Patients who received specialized cancer PT/OT were highly likely to recommend rehabilitation. Feeling comfortable with the rehabilitation process and making observable improvements in health and/or functioning influenced likelihood to recommend. Rehabilitation providers should leverage the findings of this study optimize access to and quality of cancer rehab services.

Background: Adults with cancer who are pre-frail or frail are at risk of poor outcomes. Geriatric assessment (GA) is recommended to assess and manage vulnerability and risk of frailty in older adults with cancer (≥65) and to inform referrals in supportive services, including rehabilitation. Yet, adoption of the GA in community oncology practice lags, and frailty among adults younger than 65 often goes undetected and/or unaddressed. We evaluated the feasibility of a GA-guided rehabilitation care model and assessed changes in patient-reported and performance-based outcomes after rehabilitation. Methods: Adults (≥18 years) starting systemic therapy at a community oncology practice enrolled in the study. The GA was administered online and monthly for one year. Frailty/pre-frailty was identified using a previously validated 44-item index. The oncology team was notified of frail/pre-frail patients and then made referrals to outpatient rehabilitation. Feasibility outcomes (recruitment, retention, fidelity) and participant acceptability [7 items, 0–5 Likert scale] were analyzed descriptively. Patient-reported and performance-based outcomes were examined using the paired t-test. Results: 48% of eligible patients enrolled (N = 141), and 83% completed at least one GA. Frailty/pre-frailty was identified in 40% of the GAs, resulting in 282 referrals to rehabilitation (99% fidelity). Acceptability scores ranged from 3.5 ± 1.7 to 4.7 ± 0.6. Participants who attended rehabilitation (52%) improved significantly in outcomes measuring health-related quality of life, mobility, aerobic capacity, and strength (all p < 0.05). Conclusion: Implementing a GA-guided rehabilitation care model was feasible and acceptable to patients receiving systemic treatment. Those who attended rehabilitation experienced significant improvement in patient-reported and performance-based outcomes.

Physical therapists continue to take on increased levels of autonomy within the medical field, often serving as points of entry into the health care system. The increased responsibility for diagnosis, referral, and supervision of patients requires that clinicians possess a depth of knowledge to effectively manage the patient. The expansion of specialty practice is necessary to meet the needs of a health care system that is increasingly focused on the value of delivered services. Residency programs are uniquely positioned to meet the demands of quality by providing intensive training for clinicians in a specialty area. The structure and learning environment of a residency program is conducive to the development and practice of advanced clinical reasoning skills and the organization of knowledge across the spectrum of patient complexity. By executing the delivery of care efficiently and effectively, residency graduates bring value not only to the patient but also to their organization, the specialty, and the health care system as whole. The purposes of this perspective article are (1) to examine the role of residency education within the context of the health care system, (2) to explore the relationship between value and residency pedagogy, and (3) to identify key components that drive quality in residency education.

Despite the well-documented multifactorial effects of cancer treatment, including anorexia, anemia, cancer-related fatigue, blunted immune and endocrine functioning, and biopsychosocial distresses, sarcopenia is not often recognized and assessed by healthcare staff. Recognizing and addressing this potential gap in care is extremely important for rehabilitation professionals working with individuals affected by cancer for many reasons, including the opportunity for preventative education and improved access to rehabilitative treatment.

Purpose: Chemotherapy is associated with multiple side effects (e.g., fatigue, functional decline, emotional distress), but research suggests that the side effects can be mitigated or prevented through regular engagement in physical activity. Yet, there is a known decline in physical activity during chemotherapy. Understanding what a woman affected by breast cancer experiences during chemotherapy may provide insight into ways to increase physical activity engagement. This study explores the experience of women with breast cancer receiving chemotherapy and how they navigate physical activity participation during chemotherapy. Methods: Ten semi-structured qualitative interviews were conducted with women receiving chemotherapy for the treatment of breast cancer from June to October 2024. Results: The results were synthesized using a reflexive thematic analysis approach; identifying one overarching theme and four sub-themes. The four sub-themes provided specific insights into why physical activity participation was experienced differently during chemotherapy. Going through chemotherapy changed how the women spent their time, how they interacted with people around them, and the roles they fulfilled. Chemotherapy exposed simple tasks (e.g., shower, walking upstairs) that the women previously did not consider physical activity, as activities that expended a significant amount of energy. During chemotherapy, each day felt different so the decision to participate in physical activity balanced on how the women felt, or anticipated feeling, and the perceived benefits or risks of participating. Conclusion: Healthcare providers have new insights from women with breast cancer to best recommend relevant and achievable physical activity goals and help address physical activity deficits during chemotherapy.