Breast Cancer Impairment Knowledge Study (BRIKS)

Project: Research project

Project Details

Description

Breast cancer survivors (BCS) constitute 22% of the 15.5 million U.S. cancer survivors. At least twenty-five percent of these individuals are living with cancer-related side effects and impairments. Currently 62% of all cancer survivors are over the age of 65 years-old and this is expected to grow to 73% as the survivor population is expected to exceed 26 million by 2040. Comorbidity burden is currently highest in the oldest survivors (those ≥85 years). Further, the cost of cancer care is expected to rise by 39% and reach $173 billion by 2020, exactly when the cancer survivor population is expected to exceed 18 million. The combination of aging with persistent impairments, comorbidity and the burden of health care-related debt place elderly BCS at a high and costly risk for erosion of function, disability and with ever growing needs for early detection and prevention of impairments. BCS report that the time between diagnosis and surgery is short and intensely overwhelming and that they lack knowledge about impairments and their rehabilitation, as well as how to detect impairments, move safely, and progress movement after surgery to return to regular activities, including undertaking fitness programs.
Our research supports a small but growing number of studies that identify: (1) unique needs of BCS that include under-studied impairments and disability that fall under the scope of practice of ; (2) lack ofoncology specialist knowledge about breast cancer (BC)-related impairments and the role of rehabilitation to manage impairments; and (3) reasons patients may or may not be receptive to rehabilitation services. Specifically, we have found that BCS report: (1) an average of 2.5 impairments persisting for nearly 12 years;
(2) > 80% report the need for pre-surgical self-management education on impairments and movement after surgery; (3) significantly reduced shoulder range of motion prior to surgery – even after controlling for age, medical history and other sociodemographics (race, ethnicity, income and education); (4) despite having signs and symptoms consistent with lymphedema these were not significantly related to a lymphedema diagnosis; (5) despite high levels of impairments, less than 20% are referred to PT to manage impairments. Despite these levels of impairments and the well-known effects of exercise for cancer survivors, education on self-management
of impairments is notably absent from BC usual care. Together, these results point to the need to systematically examine beliefs of BCS and oncology specialists about breast cancer-related impairments and the role of PT in the treatment of BCS. Our central hypothesis is health beliefs about breast cancer-related impairments and the role of PT may explain under- utilization of PT for BCS.

Therefore, the Specific Aims for this pilot study are to:
Aim 1: Compare health beliefs about breast cancer-related impairments and PT to treat impairments between BCS and oncology specialists. Compared to oncology specialists (physicians and oncology nurse practitioners), we hypothesize that BCS will have higher mean scores about susceptibility to breast cancer-related impairments; lower mean scores of benefits of PT to treat impairments; higher mean scores of fear of PT to treat impairments; lower mean scores for self-efficacy for management of impairments.
Aim 2: Assess reasons for and referral patterns to PT to manage impairments by breast cancer oncology specialists (physicians and nurse practitioners). We hypothesize that physicians and nurse practitioners will not differ in terms of id
StatusFinished
Effective start/end date1/1/1712/31/18

Funding

  • Foundation for Physical Therapy (FPT 03/20/2017)

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