The implementation of post breast cancer surgery physical therapy instructions for patients―A case study of Israeli medical centers
1Physical Therapy Department, Faculty of Health Sciences, Ariel University, 4076405 Ariel, Israel
2Oncology-Plastic Surgery Departments, Tel Aviv Sourasky Medical Center, 6423906 Tel-Aviv, Israel
3Private Practice, Maagan Michael, 3780500 Maagan Michael, Israel
4Division of Oncology, Rambam Health Care Center, 3525408 Haifa, Israel
DOI: 10.22514/ejgo.2022.062 Vol.43,Issue 6,December 2022 pp.96-103
Submitted: 04 August 2022 Accepted: 09 October 2022
Published: 15 December 2022
That patients undergoing breast cancer (BC) surgery need instruction post-surgery has been well described in the literature. Therefore, new off and online patient instructions have been developed and made available in Israel. This study aimed to evaluate the degree to which these instructions reach patients in Israeli medical centers and reasons for use or non-use. A case study. The study population were managers of physical therapy services in Israeli medical centers. Telephone interviews, using a semi structured questionnaire, were recorded and transcribed. The research team summarized and discussed the issues raised. Managers of physical therapy service or representative from 18 public medical centers were interviewed. All medical centers employ a full or part time physical therapist in their surgical wards and all except one provide some pre-discharge instructions to all or to selected women after BC surgery. Nine interviewees think that the new instruction is suitable as is. Disagreeing opinions were that the content is too long and not suitable for all patients. In medical centers with strong interdisciplinary cooperation there is greater use of the new instruction. Online distribution of instruction to the managers of the PT services in medical centers helped encourage their use. Instruction promotion can be increased through interdisciplinary cooperation, educational seminars, staff meetings and electronic media.
Breast cancer; Information-provision; Instruction; Physiotherapy; Side-effects
Tamar Jacob,Ruth Peleg,Jillian Bracha,Helena Silman Cohen. The implementation of post breast cancer surgery physical therapy instructions for patients―A case study of Israeli medical centers. European Journal of Gynaecological Oncology. 2022. 43(6);96-103.
 Jacob T, Silman Cohen H, Bracha J, Peleg R. Importance of standardized and on-line instructions for women after breast cancer surgery was emphasized by the lockdown during the Covid-19 crisis—A clinical letter. International Journal of Physiotherapy. 2020; 7: 216–225.
 Jacob T, Bracha J, Peleg R, Epstein A, Yosha I. Risk reduction recom-mendations for upper quadrant side effects after breast cancer surgery and treatments: a Delphi survey to evaluate consensus among expert physical therapists and alignment with current evidence. Rehabilitation Oncology. 2021; 39: E106–E118.
 Berger O, Grønberg BH, Loge JH, Kaasa S, Sand K. Cancer patients’ knowledge about their disease and treatment before, during and after treatment: a prospective, longitudinal study. BMC Cancer. 2018; 18: 381.
 Hanna L, Grothaus K, Peterson ML, Bertram S. Breast cancer survivors’ perceptions of the delivery of lymphedema education in the United States. Journal of Women’S Health Physical Therapy. 2017; 41: 137–144.
 Keesing S, Rosenwax L, McNamara B. A call to action: the need for improved service coordination during early survivorship for women with breast cancer and partners. Women & Health. 2019; 59: 406–419.
 Rethorn ZD, Pettitt CD. What is the effect of health coaching delivered by physical therapists? A systematic review of randomized controlled trials. Physical Therapy. 2019; 99: 1354–1370.
 Jacob T, Bracha J. Lymphedema treatment certified physical therapists’ awareness of and practice patterns for side effect risk reduction after breast cancer treatments. International Journal of Physiotherapy. 2019; 6: 224–230.
 New instruction/guidance for patients after breast cancer surgery. 2022. Available at: http://www.ipts.org.il/?CategoryID=180& ArticleID=1843 (Accessed: 25 August 2022).
 Physical rehabilitation after breast cancer surgery. 2022. Available at: https://www.stop-cancer.co.il/livewithit-category/%d7%a9%d7%99%d7%a7%d7%95%d7%9d-%d7%9c%d7%9e%d7%97%d7%9c%d7%99%d7%9e%d7%95%d7%aa-%d7%9e%d7%a1%d7%a8%d7%98%d7%9f-%d7%94%d7%a9%d7%93/ (Accessed: 25 August 2022).
 Armer JM, Hulett JM, Bernas M, Ostby P, Stewart BR, Cormier JN. Best-practice guidelines in assessment, risk reduction, management, and surveillance for post-breast cancer lymphedema. Current Breast Cancer Reports. 2013; 5: 134–144.
 NLN Position Papers. 2020. Available at: https://lymphnet.org/position-papers (Accessed: 01 July 2020).
 Schmitz KH, Campbell AM, Stuiver MM, Pinto BM, Schwartz AL, Morris GS, et al. Exercise is medicine in oncology: engaging clinicians to help patients move through cancer. CA: A Cancer Journal for Clinicians. 2019; 69: 468–484.
 Playdon M, Ferrucci LM, McCorkle R, Stein KD, Cannady R, Sanft T, et al. Health information needs and preferences in relation to survivorship care plans of long-term cancer survivors in the American Cancer Society’s study of Cancer Survivors-I. Journal of Cancer Survivorship. 2016; 10: 674–685.
 Abouelazayem M, Elkorety M, Monib S. Breast lymphedema after conservative breast surgery: an up-to-date systematic review. Clinical Breast Cancer. 2021; 21: 156–161.
 Boughey JC, Hoskin TL, Cheville AL, Miller J, Loprinzi MD, Thomsen KM, et al. Risk factors associated with breast lymphedema. Annals of Surgical Oncology. 2014; 21: 1202–1208.
 Ellegaard MB, Grau C, Zachariae R, Jensen AB. Women with breast cancer report substantially more disease- and treatment-related side or late effects than registered by clinical oncologists: a cross-sectional study of a standard follow-up program in an oncological department. Breast Cancer Research and Treatment. 2017; 164: 727–736.
 Hayes SC, Johansson K, Stout NL, Prosnitz R, Armer JM, Gabram S, et al. Upper-body morbidity after breast cancer. Cancer. 2012; 118: 2237–2249.
 Ridner SH. Pretreatment lymphedema education and identified ed-ucational resources in breast cancer patients. Patient Education and Counseling. 2006; 61: 72–79.
 Springer BA, Levy E, McGarvey C, Pfalzer LA, Stout NL, Gerber LH, et al. Pre-operative assessment enables early diagnosis and recovery of shoulder function in patients with breast cancer. Breast Cancer Research and Treatment. 2010; 120: 135–147.
 Yang A, Sokolof J, Gulati A. The effect of preoperative exercise on upper extremity recovery following breast cancer surgery: a systematic review. International Journal of Rehabilitation Research. 2018; 41: 189–196.
 Khan F, Amatya B, Pallant J, Rajapaksa I, Brand C. Multidisciplinary rehabilitation in women following breast cancer treatment: a randomized controlled trial. Journal of Rehabilitation Medicine. 2012; 44: 788–794.
 Taylor C, Shewbridge A, Harris J, Green JS. Benefits of multidisciplinary teamwork in the management of breast cancer. Breast Cancer. 2013; 5: 79–85.
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